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Skin cancer on the rise among young women


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By Emma G. Fitzsimmons, New York Times

On a hot July day last summer, I was lying on the beach at Coney Island with my younger brother when he noticed a dark mole on the back of my arm. “You should really get that checked at the dermatologist,” he said in a worried tone.

It turned out that the mole on my arm was fine, but another one on my cheek was basal cell skin cancer. A few weeks later, I had surgery to remove it and left the plastic surgeon’s office with a 1.5-inch scar sloping down my right cheek.

Friends and colleagues were surprised to see the scar because I was only 28. Even the medical resident who attended my operation said I was the youngest skin cancer patient she had met.

People flock to the beaches of Lake Tahoe on Fourth of July weekend. Photo/LTN

People flock to the beaches of Lake Tahoe on Fourth of July weekend. Photo/LTN

But as I learned more about skin cancer, I discovered that it is becoming increasingly common, especially among young women. A recent study by the Mayo Clinic found that melanoma, the most serious type, had increased eightfold for women under 40 since 1970.

“There is this thought that, ‘It won’t happen to me because I’m young,’ but that’s not true anymore,” said Dr. Jerry Brewer, a dermatologist at the Mayo Clinic and an author of the study.

Experts say that tanning beds are a major factor behind the increase in all three types of skin cancer for young women. More than 20 million people use tanning beds each year, and 70 percent of customers are young white women, who are at increased risk of developing skin cancer. The lamps in tanning beds can give off 10 to 15 times the UVA radiation of normal sun exposure, accelerating the process of skin damage. Instead of getting skin cancer 30 or 40 years down the line, many young women are getting it five or 10 years later, Dr. Brewer said.

Though I have never used a tanning bed, my dermatologist said I had an unlucky trio of risk factors: fair skin and blue eyes, an upbringing in Texas, where I spent long days in the sun growing up, and a family history of skin cancer. My grandmother and aunt had melanoma and survived, and my mother had basal cell carcinoma too.

While more than three million cases of basal and squamous cell carcinoma are diagnosed each year, only about 2,000 people a year die from these non-melanoma skin cancers. Melanoma is a far more ominous diagnosis, causing about 9,400 deaths each year in the United States.

Dr. Darrell Rigel, a dermatology professor at NYU Langone Medical Center, says that every month at his New York practice, about two women in their 20s are found to have early melanoma, a dramatic rise from 20 years ago. Once melanoma is the size of a dime, there is a good chance that it has already spread and treatment may not work, Dr. Rigel said. “I know I’m looking at a death sentence on their arm, and they feel perfectly fine,” he said. “It’s absolutely awful.”

This year, the Food and Drug Administration proposed new regulations for tanning beds that require them to have labels warning that they are not recommended for people under 18. And in April, New Jersey joined several other states in passing a law to prohibit indoor tanning for those under 17.

Even children can get melanoma. A recent study in the journal Pediatrics found that the number of cases among children and adolescents has been increasing each year by about 2 percent.

Another recent study, published in The Journal of the American Medical Association, found that while young women are more likely to be given a diagnosis of melanoma, young men are more likely to die from it. Researchers said the disparity was probably a consequence of behavioral tendencies — men are less likely to see a doctor or perform a skin self-examination — and possibly biological differences as well.

My brush with skin cancer has certainly changed how I view the sun. I don’t want another scar — or worse, a diagnosis of melanoma. I wear a 30 SPF sunscreen on my face every day and bought several sun-protective long-sleeve shirts to wear outdoors this summer. I am visiting my dermatologist every three months for a full body scan. (One annual checkup is recommended for those without a previous diagnosis.)

I returned to Texas in April for a friend’s wedding at a resort in the woods. After a long winter in New York, my husband and I were excited to go swimming at a pool near our cabin. In the past, I would have grabbed a lounge chair in the sun, seeing it as the perfect opportunity to arrive at the ceremony with a sun-kissed glow. But this time, I picked a chair under a wide umbrella. It’s just not worth it anymore.

Even a few sunburns can significantly raise your risk of skin cancer, Dr. Brewer said.

“Deciding how much sun you want to get is like asking how much cyanide you want in your breakfast cereal,” he said. “There is no amount of tan that is healthy.”

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