Lifelines
Published: Spring 2006; Vol. 8 No. 2

Melanoma Rates Rising among Latinos

Melanoma rates among Latino men are rising at twice the rate of white men, according to a recent study in California (Developing Epidemic of Melanoma in the Hispanic Population of California, Cancer 2006;106;1162-8). Melanoma is the most deadly kind of skin cancer.

This increase suggests that Latinos should use more sunscreen and other protections and that they and their health care providers should be more careful in checking for signs of melanoma. The study’s authors specifically challenge the theory – widespread among Latinos and many doctors as well – that Latinos are less susceptible to skin cancer due to stronger pigmentation in their skin.

The study examined 14 years (1988-2001) of health care data that included all melanomas identified in California. Overall, while the increase in the rate of melanoma among Latino men was 1.8 percent per year, it jumped sharply to seven percent for the last five years. By comparison, among white men, the rate increased 3.9 percent per year over the course of the study.

More alarming, however, was that almost all of the increase in melanoma among Latinos was in the incidence of thick tumors, those thicker than 1.5 millimeters. Among Latinos these have been increasing at the rate of 15 percent per year, accounting for 35.4 percent of all melanomas by the end of the study. Among whites, they account for 24.4 percent.

While the survival rate for thinner melanomas ranges from 80 to 100 percent, the rate for thick melanomas is only 40 to 80 percent.

“When the tumor is thick, that usually means it has been developing for a while,” says the study’s lead epidemiologist, Myles G. Cockburn of the University of Southern California. “This is a disease that has a great chance of cure when found early. But in this population, the cancer is becoming more common and it is not being caught early enough.”

The extent of solar protection provided naturally to Latino men and women by the pigmentation in their skin is largely undetermined. Even African-Americans sunburn and can be stricken with skin cancer. At least one study shows that Latinos, despite their skin color, burn as much as Caucasians, suggesting that they may be quite susceptible to skin cancer.

“We don’t know why the melanoma rate among Latino men rose so fast in recent years,” Cockburn says. “One reason could be a change in what researchers call ‘cohort behavior.’” A better theory might have to do with what actually causes melanoma. “Basal and squamous skin cancers are definitely caused by solar radiation, but it is less clear what causes melanoma and the sun isn’t always the biggest risk factor,” says Cockburn.

Cockburn notes, however, that skin cancer prevention practice among Latinos does not appear widespread. One study showed that sunscreen use was significantly less prevalent among Latino than white high school students. Two studies showed that Latinos have a lower perception of their risks than whites. Another study showed that whites are twice as likely as Latinos to have conducted self-examinations for signs of skin cancer.

While the message of solar protection has gotten out to the white population, it is clearly lagging among Latinos. “While we don’t know exactly why melanoma rates are increasing among Latinos,” Cockburn stresses, “the disproportionate number of thick melanomas is clear evidence that Latino patients and their doctors are not checking carefully for early signs of melanoma. Latinos and their doctors ought to take this risk much more seriously.”