Patients and Skin Cancer Statistics: What Dermatologists Should Know
Skin cancer remains “the most common cancer in the United States,” according to the American Academy of Dermatology, with about 9,500 people in the country receiving a skin cancer diagnosis every day.
Yet a recent survey shows that Americans are not as concerned as they should be about skin cancer statistics and their personal risk, and more education from dermatologists and other physicians may be needed. In addition, the Skin Cancer Foundation has changed how it determines the percentage of nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
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Few Americans Concerned About Skin Cancer Risk
The June 2021 study from the American Academy of Dermatology (AAD) found only one-third of U.S. citizens are concerned about skin cancer, even though nearly 70 percent have at least one risk factor.
While anyone can get skin cancer, the risk increases for people with the following characteristics: lighter natural skin color, skin that burns or reddens easily, blue or green eyes, red or blonde hair, more than 50 moles, and a family or personal history of skin cancer.
Among the AAD survey respondents:
- 49 percent said they are more worried about avoiding sunburn than preventing skin cancer
- 32 percent said they are more worried about avoiding wrinkles than preventing skin cancer
- 25 percent said they got a sunburn in 2020
“These findings are surprising and seem to suggest that many people do not take skin cancer seriously or perhaps believe skin cancer won’t happen to them,” said board-certified dermatologist Robert T. Brodell, MD, FAAD, professor and founding chair of the department of dermatology and professor of pathology at the University of Mississippi Medical Center, in the AAD press statement.
"Yet, one in five Americans will develop skin cancer in their lifetime, and nearly 20 Americans die from melanoma, the deadliest form of skin cancer, every day,” he added.
Nonmelanoma skin cancers can also be deadly, thus prevention and early detection are key. The Skin Cancer Foundation reports that about 90 percent of nonmelanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun.
As summer is well underway, dermatologists and other physicians are encouraged to talk to their patients about sun protection, preventing skin cancer, and doing skin self-exams.
The AAD’s #PracticeSafeSun campaign can help physicians raise awareness with their patients and provide additional resources.
Changes In Skin Cancer Statistics
Among current skin cancer statistics, the AAD estimates that more than 1 million Americans are living with melanoma and that nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), affects more than 3 million Americans each year.
The AAD website also notes that research has found the overall incidence of BCC increased by 145 percent between 1976-1984 and 2000-2010, and the incidence of SCC increased 263 percent over that same period.
While the incidence of melanoma is tracked by the Centers for Disease Control and Prevention’s National Cancer Registries, basal cell carcinoma and squamous cell carcinoma are not tracked. The Skin Cancer Foundation had used a ratio of 4:1 to estimate the number of nonmelanoma skin cancers. But now that will change to a 2:1 ratio.
“Consistent with the Skin Cancer Foundation article, we also find that the ratio of 2:1 -- basal cell carcinoma: cutaneous squamous cell carcinoma -- better reflects the 2021 nonmelanoma skin-cancer patient incidence ratio,” said David Hartman, MD, at the one-physician Facial Plastic Surgery office in Dover, Ohio.
Why The Nonmelanoma Skin Cancer Ratio Is Changing
About 5.4 million cases of nonmelanoma skin cancer are diagnosed every year, affecting more than 3.3 million Americans. The Skin Cancer Foundation reviewed a couple of studies before changing the skin cancer statistic metrics.
A 2015 study in JAMA Dermatology reported a 1:1 ratio for the two nonmelanoma skin cancers. Then a 2020 study in the same journal assessing whether basal cell and squamous cell cancers differ with age, sex, race, and geographic region in the United States, found basal cell carcinomas were 1.69 times more likely than squamous cell carcinomas. It concluded that “basal cell carcinomas were more common than squamous cell carcinomas for all demographics.”
With the new metric, the Skin Cancer Foundation estimates 3.6 million nonmelanoma cases in the United States involve basal cell carcinomas (BCC) and 1.8 million involve cutaneous squamous cell carcinomas (CSCC) each year.
“In general, BCC is more likely to occur in younger, more often female, patients who have had several severe sunburns, including sunbathers; whereas, CSCC is more likely to occur on older, more often male patients who have had decades of chronic sun exposure, including farmers, golfers, snowbirds, etc.,” Hartman said.
Changes in how the foundation calculates skin cancer statistics will likely have little impact on dermatologists and patients. The most important things are to increase awareness about prevention and the importance of screening. Even nonmelanoma skin cancers can prove deadly.
The Skin Cancer Foundation reports more than 15,000 people to die of squamous cell carcinoma of the skin annually in the United States.
“CSCC actually occurs most commonly in clusters, such that roughly half of the CSCC removals that I do involve a larger/longer skin-cancer specimen that contains two to 10 individual CSCCs, especially on those body areas of chronic sun exposure, such as on the temporal face and forehead area, pre-auricular face, scalp, or dorsal forearms/hands for instance,” Hartman said.
Managing Skin Cancer
The high incidence of skin cancer increases the demand for plastic surgery and dermatology jobs. Treatment often requires surgery to remove a BCC or CSCC. If the skin cancer is near an enlarged lymph node, the physician will biopsy the node or remove it if it contains cancer cells. Other treatments, including cryotherapy, photodynamic therapy, topical chemotherapy, and other modalities might be used if cancer has not spread.
Multiple locum tenens plastic surgery and dermatology jobs are available at Staff Care, as many facilities fill temporary vacancies with locum physicians.