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DEPARTMENTS: Editorial

Skin Cancer Rates Rising

Davis, Kyleen E. MSN, FNP-BC, DCNP

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Journal of the Dermatology Nurses’ Association: May/June 2020 - Volume 12 - Issue 3 - p 113-114
doi: 10.1097/JDN.0000000000000543
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Skin cancer is the most common cancer in the United States (Guy et al., 2015). It is estimated that one in five Americans will develop skin cancer in their lifetime, leading to significant morbidity and healthcare costs (American Academy of Dermatology, 2020). In the United States, more people are diagnosed with skin cancer each year than all other cancers combined (The American Cancer Society Medical and Editorial Content Team, 2019). Basal cell and squamous cell carcinomas, also known as nonmelanoma skin cancer (NMSC), are the two most common forms of skin cancer and are highly treatable if detected early. Research shows that the diagnosis and treatment of NMSC in the United States have increased by 77% between 1994 and 2014 (Mohan & Chang, 2014). Women and individuals younger than the age of 40 years have the greatest increase in incidence rates for NMSC (Muzic et al., 2017; Figure 1).

FIGURE 1
FIGURE 1:
Invasive squamous cell carcinoma on the anterior shoulder. Photo courtesy of Maral Skelsey, MD, Dermatologic Surgery Center of Washington. Used with permission.

Melanoma, the most serious form of skin cancer, is highly treatable when detected in its earliest stages. However, as melanoma advances, it can metastasize to the lymphatic system and internal organs, resulting in a poor prognosis (American Academy of Dermatology, 2020). Unfortunately, melanoma rates are rising swiftly. A recent epidemiological study in Olmstead County, Minnesota, revealed that, during the years of 1970–2009, there was an 800% increase in melanoma diagnosis in young women, aged 18–39 years, and a 400% increase in men of the same age (Reed et al., 2012). Researchers predict that, in the year 2020, 100,350 new melanoma cases will be diagnosed in the United States, with approximately 6,850 people expected to die from this condition (The American Cancer Society Medical and Editorial Content Team, 2019; Figure 2).

FIGURE 2
FIGURE 2:
Acral lentiginous melanoma on the plantar foot. Photo courtesy of Maral Skelsey, MD, Dermatologic Surgery Center of Washington. Used with permission.

The increase in the incidence of skin cancer can be mainly attributed to the use of artificial sunlamps and intense exposure to ultraviolet (UV) light (Bolognia et al., 2012). It has been shown that individuals who use tanning beds before the age of 35 years increase their risk for melanoma by 75% (International Agency for Research on Cancer Working Group on Artificial Ultraviolet [UV] Light and Skin Cancer, 2007). Furthermore, only one blistering sunburn during childhood or adolescence nearly doubles a person's chance of developing melanoma (Global Burden of Disease Cancer Collaboration, 2019). If five or more blistering sunburns occur between the ages of 15 and 20 years, the risk of melanoma increases by 80% (Global Burden of Disease Cancer Collaboration, 2019). Unprotected exposure to the sun's UV rays remains the most preventable risk factor for skin cancer, and broad-spectrum sunscreens can help reduce this risk (American Academy of Dermatology, 2019). Despite greater public awareness on the harms of tanning and the importance of sunscreens and sun protection, individuals continue to engage in unsafe behaviors that expose themselves to damaging UV radiation.

It is imperative that dermatology nurses have an excellent grasp on the prevention, detection, and management of all types of skin cancer, as they can expect to encounter many more patients with these conditions in the future. With the Journal of the Dermatology Nurses' Association continued commitment to covering important clinical topics that dermatology nurses rely on, a new column has been developed, entitled “Skin Cancer: The Basics.” This column is intended to be an overview of the critical information nurses should know regarding the topic of skin cancers. In the previous issue of Journal of the Dermatology Nurses' Association, the column reviewed the epidemiology, assessment, and treatment of basal cell carcinoma—the most common type of skin cancer (Davis, 2020). In the future, readers can expect to learn more about other skin cancers—such as squamous cell carcinoma, melanoma, and actinic keratoses—as well as expand their knowledge of the various types of skin cancer treatments. We encourage readers to actively participate in this new column by suggesting ideas, writing articles, and providing feedback. By committing to being well-informed and up-to-date on the most commonly encountered carcinomas of the skin, the dermatology nurse can help in the fight against this serious health burden.

Kyleen E. Davis, MSN, FNP-BC, DCNP

Dermatologic Surgery Center of Washington,

Chevy Chase, MD

kyleen.davis1@gmail.com

REFERENCES

American Academy of Dermatology. (2019, May 22). The American Academy of Dermatology statement on the safety of sunscreen [Press release]. https://www.aad.org/news/aad-safety-of-sunscreens
American Academy of Dermatology. (2020). Skin cancer incidence rates. Retrieved February 18, 2020, from https://www.aad.org/media/stats-skin-cancer
Bolognia J. L., Jorizzo J. L., & Schaffer J. V. (Eds.) (2012). Dermatology (3rd ed.). Elsevier Saunders.
Davis K. (2020). Skin cancer, the basics: Basal cell carcinoma. Journal of the Dermatology Nurses' Association, 12(2), 78–84.
Global Burden of Disease Cancer Collaboration. (2019). Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990–2017. Journal of the American Medical Association Oncology, 5(12), 1749–1768.
Guy G. P. Jr., Thomas C. C., Thompson T., Watson M., Massetti G. M., & Richardson L. C., Centers for Disease Control and Prevention (2015). Vital signs: Melanoma incidence and mortality trends and projections—United States, 1982–2030. Morbidity and Mortality Weekly Report, 64(21), 591–596.
International Agency for Research on Cancer Working Group on Artificial Ultraviolet (UV) Light and Skin Cancer. (2007). The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. International Journal of Cancer, 120(5), 1116–1122.
Mohan S. V., & Chang A. L. (2014). Advanced basal cell carcinoma: Epidemiology and therapeutic innovations. Current Dermatology Reports, 3, 40–45.
Muzic J. G., Schmitt A. R., Wright A. C., Alniemi D. T., Zubair A. S., Olazagasti Lourido J. M., Sosa Seda I. M., Weaver A. L., & Baum C. L. (2017). Incidence and trends of basal cell carcinoma and cutaneous squamous cell carcinoma: A population-based study in Olmsted County, Minnesota, 2000 to 2010. Mayo Clinic Proceedings, 92(6), 890–898.
Reed K. B., Brewer J. D., Lohse C. M., Bringe K. E., Pruitt C. N., & Gibson L. E. (2012). Increasing incidence of melanoma among young adults: An epidemiological study in Olmsted County, Minnesota. Mayo Clinic Proceedings, 87(4), 328–334.
The American Cancer Society Medical and Editorial Content Team. (2019). Risk factors for melanoma skin cancer. Retrieved February 18, 2020, from https://www.cancer.org/cancer/melanoma-skin-cancer/causes-risks-prevention/risk-factors.html
Copyright © 2020 by the Dermatology Nurses' Association.