(Un)healthy glow causes epidemic

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The March edition of the Archives of Dermatology, a peer-reviewed medical journal, focuses on skin cancer with new studies highlighting the growing epidemic of non-melanoma skin cancers (NMSC).

NMSC is a term used to reference two types of malignant skin tumors: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). It is believed to be the most common skin cancer caused by too much UV exposure from both natural and unnatural sources. Both are rarely fatal but can cause a range of health problems from bone damage, disfigurement and cancer growth in other organs.

The recent studies and editorials map the epidemic by offering new insights into incidence rates, prevalence and causes.

Maria L. Chanco Turner, MD, a Washington DC-based dermatologist and editorialist for Archives of Dermatology explained, "Epidemiological and molecular studies provide supporting evidence that solar radiation is a major carcinogen for nonmelanoma skin cancers and melanomas."

Robert S. Stern, MD, a dermatologist and researcher at the Dana-Farber/Harvard Cancer Center, concluded in his incidence-based study that, "The prevalence of a skin cancer history is about 5 times higher than that of breast or prostate cancer and greater than the 31-year prevalence of all other cancers combined. Despite their high frequency, population-based incidence and burden data for BSC and SCC are largely lacking."

Stern found, "About 1 in 5 seventy-year-olds have had NMSCs, and most of those affected have had multiple NMSCs." And, "approximately 13 million white non-Hispanics living in the United States at the beginning of 2007 have had at least 1 NMSC."

Howard W. Rogers, MD, PhD, a dermatologist in Norwich, Connecticut and lead author of another study on NMSC prevalence, said "we are dealing with a problem that is not going away. The number has kept going up and up at a rate of 4.2 percent every year, on average, from 1992 to 2006."

Rogers and his research team found that the "total number of procedures for skin cancer in the Medicare fee-for-service population increased by 76.9%" in a 14-year time span. With the baby-boomer generation aging, the amount of NMSC is expected to rise and continue to be an ongoing health challenge.

According to HealthDay, a health news service, "researchers from Erasmus University Medical Center in Rotterdam, the Netherlands, called for a ‘revised health strategy' that treats skin cancer as a chronic disease requiring not just a one-time treatment, but ongoing monitoring of patients, prevention and education."

Dr. Suephy Chen, an associate professor of dermatology at Emory University School of Medicine, explained, "this is only going to get worse, our population is aging. Those people who grew up in the 1970s and 1980s when there was not a big sun-protection message out there are now coming into their 50s and 60s and are starting to develop skin cancers."

"Think of sun exposure like putting money in a bank that you can't withdraw," Rogers said. "You can't get rid of the damage you have, but continued sun exposure accelerates the rate at which you will develop new skin cancers. Protecting your skin from the sun will help decrease the rate."

Chen also explained the economic burden of skin cancer to the US health care system, in another recent study published in the Archives of Dermatology, "It's a huge difference in the cost of taking care of a stage 1 versus a stage 4 patient. It makes a lot of sense to invest in early detection and prevention measures. We found the annual cost of melanoma to be up to $249 million and the per-patient lifetime costs to be $28,210 from the time of diagnosis to the time of death."

Full studies and editorials available in the March edition of the Archives of Dermatology: http://archderm.ama-assn.org

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