As a North African American, I grew up thinking that my dark skin made me invincible to skin cancer. It wasn’t until my first week of dermatology residency that I learned I was wrong. I had an appointment with an elderly Black woman who came into our clinic for a skin check, and I didn’t see anything suspicious. Then, my attending dermatologist, a skin of color expert, came in to double check, and he instantly identified a shiny, black growth on her face as basal cell skin cancer. I had never seen skin cancer in dark skin before. It was a humbling lesson that I still carry into my practice every day.
Many people don’t realize that skin cancer can affect all shades, but recognizing and treating it early is key. We can protect ourselves by learning what to look out for.
How common is skin cancer in people of different races?
Skin cancer is the most common cancer in the United States, but it isn’t clear how much it affects different racial groups. According to a research paper from 2009, skin cancer makes up as much as 45% of all cancers in white people, 5% of all cancers in Hispanic people, 4% of all cancers in Asian people, and 2% of all cancers in Black people.
Skin cancer is becoming more and more commonly diagnosed in white people, but in Black people, the rate of skin cancer seems to be staying low. However, when skin cancer is diagnosed in people of color, the tumor is often bigger, more advanced, and deadlier.
Take squamous cell carcinomas, for example. This type of skin cancer is 10 times more likely to spread if it happens in Black people compared to in white people. Looking at melanoma (another type of skin cancer), a study from 2017 that analyzed a database of patients from 1988 to 2011 found that 92% of white patients were alive 5 years after they were diagnosed compared to just 72% of African Americans.
We know that skin pigmentation provides some protection from cancer, which might partially explain the lower rate of skin cancer among people of color. But there is also a lack of awareness among providers and patients that can lead to delays in diagnosis or a diagnosis being overlooked.
Early diagnosis is critical for treating skin cancer successfully. Before we dive into more details, remember, the best thing about skin cancer is that you can see it. If you find a cancerous spot before it spreads, surgical removal or destruction cures it. This is the case regardless of skin color, so it’s important that all people learn to recognize what skin cancer looks like — and how it might look different on different shades of skin.