Don’t Get Burned: The ABCs of Skin Cancer Prevention and Detection

By Shannon Moran
02:00 AM Tue February 28, 2023

While skin cancer may be the most common cancer in the United States, proper precautions can prevent exposure. Learn more about basal cell carcinoma, squamous cell carcinoma, and melanoma and the factors that put us at risk.

Skin Cancer: The Most Common Cancer of All

Skin cancer reigns as the most prevalent form of cancer in the United States,
encompassing basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma -
listed in order of frequency. These malignancies arise from the epidermis, the outermost layer of
the skin. Specifically, SCC develops in the topmost layer of the epidermis, while BCC originates
in the basal layer, which contains the cells responsible for skin regeneration. Despite their
differing locations, both SCC and BCC (nonmelanoma skin cancers) can occur anywhere on the
body, but are most commonly found on sun-exposed areas such as the face, neck, and arms.
Melanoma, the deadliest form of skin cancer, develops from pigment-producing cells called
melanocytes, and can rapidly spread to other parts of the body, including the brain, if left
untreated (1).

The most common underlying trigger for skin cancer is exposure to ultraviolet (UV) rays
from the sun and tanning beds, which can cause DNA damage inside the cells, leading to skin
cancer, premature aging of skin, cataracts, photokeratitis, and other skin/eye ailments. It's
important to note that having a "base tan" is a sign of skin damage and is not recommended (1). Furthermore, having five or more blistering sunburns between the ages of 15-20 increases an
individual's nonmelanoma skin cancer risk by 68% and melanoma risk by 80%. Women under
30 years old who use indoor tanning are 6 times more likely to develop melanoma (2).

While anyone can develop skin cancer, certain factors put individuals at greater risk, such
as personal or family history of skin cancer, older age, lighter skin color, blue or green eyes,
naturally blond or red hair, and skin that is sensitive to the sun (1). In fact, individuals with
naturally red hair are 10-100 times more likely to develop melanoma than those with other hair
colors (3). However, with the right precautions, skin cancer can be preventable. This includes
reducing UV exposure through sun and tanning bed avoidance, wearing protective clothing,
wraparound UV-blocking sunglasses, and using sunscreen with SPF 30 or higher, which should
be reapplied every two hours, especially when the UV index is 3 or higher (which can be
determined by looking at a weather app or website). It's important to note that UV rays are
strongest in the US between 10 am - 4 pm (daylight savings time) or 9 am - 3 pm (standard
time). Also, UV rays still shine through on cloudy/overcast days, are present year-round, and can
reflect off snow, sand, cement, and water, increasing exposure (1).

The most common sign of skin cancer is a change in the skin, including a new mole or
growth, change in a mole, or a sore that does not heal, is itchy, or bleeds. Signs of melanoma can
be remembered using the ABCDE mnemonic: asymmetry (irregular shape), borders (irregular
borders), color (variation throughout the lesion), diameter (larger than pea-size), and evolution
(change over weeks/months). If any of these signs are present, it's important to visit a healthcare
provider (1).

Although the US Preventative Services Task Force has determined that there is not
enough evidence to recommend routine screening, individuals with risk factors or concerns
should talk with their medical provider. Treatments for skin cancer can be disfiguring and
include, but are not limited to, surgery and topical or systemic chemotherapeutic agents,
depending on the extent of the cancer (1).

References:
1. Centers for Disease Control and Prevention. Skin Cancer: Risk Factors. Accessed
February 23, 2023. https://www.cdc.gov/cancer/skin/basic_info/risk_factors.htm

2. American Academy of Dermatology Association. Skin cancer. Accessed February 23,
2023. https://www.aad.org/media/stats-skin-cancer

3. Cao J, Wan L, Hacker E, Dai X, Lenna S, Jimenez-Cervantes C, Wang Y, Leslie NR, Xu
GX, Widlund HR, Ryu B, Alani RM, Dutton-Regester K, Goding CR, Hayward NK, Wei
W, Cui R. MC1R is a potent regulator of PTEN after UV exposure in melanocytes. Mol
Cell. 2013 Aug 22;51(4):409-22. doi: 10.1016/j.molcel.2013.08.010. PMID: 23973372;
PMCID: PMC3792490.