Women's Health Specialists of St. Louis
Obstetrics and Gynecology

Articles - Melanoma

Melanoma is the most common type of skin cancer and the sixth most common type of cancer in the United States. The rates are currently increasing faster than any other type of cancer. It is now estimated that approximately 1 in 70 Americans will develop melanoma during their lifetime. The rise in incidence of skin cancer is suspected to be directly related to excess sun exposure in sun-sensitive people. The most convincing evidence for this relationship is that the highest incidence of skin cancer world wide is in Australia. Melanoma affects all age groups but occurs most commonly in women who are in their 50s. It is lifelong cumulative sun exposure that increases the risk of skin cancers in the 5th decade of life. People with a history of sun-sensitivity or frequent sunburns are particularly at risk. Inherited susceptibility such as a family history of melanoma will also increase risk. Approximately 10% of melanomas are due to inherited risk factors. A family history of a first-degree relative with melanoma increases the risk of developing a melanoma by approximately 10 times that of the general population. People with multiple moles and freckles are at greater risk too. Though fair-skinned individuals are at greatest risk, dark-skinned individuals also need to avoid excess sun exposure, especially if there is a family history of skin cancer.

Most skin cancers develop as single lesion on normal skin. They may occur anywhere on the skin surface but are frequently located on the back and areas that are tough to examine by self inspection. Physicians often refer to the ABCs of inspection to help patients perform self screening for skin cancer. These include: asymmetry, borders, color, diameter, and enlargement. For example, if the mole has developed a shape other than round or oval and the borders are not smooth, then further evaluation in warranted. Similarly, variation of color within the mole, a sudden growth of the mole, or absolute size more than 0.25 inches should prompt further evaluation. More specifically, a change in a mole should not be ignored. Moles that have a noticeable change in shape, color, or size need to be evaluated by a physician. Moles with inflammation, bleeding or crusting, or itching also need evaluation by a physician.

Prevention of melanoma is best achieved by both early detection of abnormal moles and sun protection against skin damage that can cause cancer. Parents need to protect their children from sun exposure to reduce the lifelong chance of cancer. Sun avoidance including sun protection with at least SPF 15 is associated with a reduction of risk. Adults should practice sun avoidance as well as skin self exam. Those with a family history or with multiple moles and freckles should have periodic skin exams by a physician in addition to monthly self exams.

Further information may be obtained from the American Academy of Dermatology at http://www.aad.org.