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Melanoma - why are we seeing record numbers lately?

Posted Jul 11 2011 5:04pm

By Rachael Combe | July 11, 2011

  • burn rate

Coco Chanel is credited (or blamed, depending on your perspective) for inventing tanning. Legend has it she got accidentally broiled on a trip to the Riviera, and her fans, thinking everything she did was glamorous and chic, began roasting themselves in imitation. Chanel, of course, could not have predicted the trend’s frightening culmination nearly a century later: Snooki.

But seriously, folks, if Snooki and her sister in drunk-and-disorderly Oompa-Loompanity, Lindsay Lohan, haven’t convinced you that the sun-baked look has become less Coco and more loco, consider this fun fact: Melanoma rates are increasing around the world, but the incidence among American women ages 15 to 39 has more than doubled over the past 30 years, rising more steeply than for any other age or gender bracket. (In absolute numbers, there are still more cases of melanoma among older people because, perhaps obviously, the longer you’re around, the more rays you catch.)

So why are young women at the red-hot center of the epidemic? According to skin cancer experts across the country, there seem to be several likely culprits.

Willful Stupidity
Melanoma is the deadliest form of skin cancer. According to the American Academy of Dermatology, one American dies from it almost every hour. And melanoma has been incontrovertibly linked to ultraviolet (UV) exposure from the sun and/or indoor tanning. “[Tanning] is a real scourge,” says David Fisher, MD, PhD, chairman of the Department of Dermatology at Massachusetts General Hospital. “There are very few cancers where we know as much about the cause. But the amazing and humiliating thing is that the incidence is still rising more steeply than for any other cancer.”

Despite knowing full well that tanning is bad for us (not to mention the wrinkles and liver spots), we don’t seem to be acting on the knowledge. A recent survey by the American Academy of Dermatology found that 81 percent of women ages 14 to 22 had tanned indoors or outdoors frequently or occasionally in the past year. This is not just people playing tennis who happen to get some sun—this is lying in the sun as recreation in and of itself, or paying money to be radiated in a tanning booth. Can you imagine if 81 percent of young women had taken up smoking last year? It’s hard to think of any other potent known carcinogen that young women partake of so blithely. (That said, while indoor tanners, for example, bump up their chances of getting melanoma by 75 percent, regular smokers increase their lung cancer risk by 1,200 percent.)

The World Health Organization categorizes UV light from indoor tanning beds as a known carcinogen and has recommended that the beds be banned except for medical use (mostly to treat psoriasis). The U.S. Food and Drug Administration barely regulates the beds, however. Fisher blames the tanning industry’s powerful lobby in Washington, DC, which spins any attempts at controlling the practice as punishing small businesses. (When Obama put through a bill levying a 10 percent tax on tanning at a salon, Snooki mouthed off about the president and urged everyone to give up indoor tanning to avoid filling public coffers—which is pretty funny, because that’s exactly the public health goal the tax was intended to achieve.) UV lamps have also been proven to cause premature aging, immune suppression, and eye damage. Though tanning beds are touted as a way to get a “base tan” and prevent sunburns, 58 percent of adolescents who use them get burned, according to a study by the American Cancer Society. And, of course, sunburns are the number-one preventable cause of melanoma.

Or Maybe It’s Not Willful…
There’s a small but growing body of evidence that our compulsion to bronze is not entirely voluntary. Some women may actually be tanaholics. One study of college women who visit tanning salons found that more than 30 percent exhibited the hallmarks of addiction, such as trying but failing to cut back, or missing social or work obligations to tan. “It’s not as outlandish as it sounds,” Fisher says. We need the sun to manufacture vitamin D, and we need vitamin D to survive. These days we can pop a vitamin, but millions of years ago as humans were evolving, we would have needed to go into the sun. So it makes sense for us to have evolved a drive to seek the sun as often as possible. And research on seasonal affective disorder (SAD)—which 4 to 6 percent of Americans suffer from—shows that the sun can boost your mood. But there’s a happy medium between living in a cave and cooking your skin until it sprouts tumors.

Women who find themselves unable to stop tanning might have more success if they treat it as a true addiction—seek help, get support, and put up some big inspirational pictures of pale beauties like Katy Perry and Mary Louise Parker (who is reportedly obsessive about sunscreen—I once saw her trying on shoes at Barneys, and, though she is 47 years old, she has the skin of an eight-year-old, I swear to Ra, the Egyptian sun god).

Blame It On Rio
You’d think that people such as farmers and construction workers who spend all day outside would be at particular risk for melanoma, yet studies have shown that continuous sun exposure actually protects against the disease (although it is impli­cated in the far less deadly non-melanoma skin cancer). Instead, melanoma is associated with intense, intermittent UV exposure, the type you get from hitting a tanning salon—or a Caribbean beach in December. “Call it the airplane effect,” says Manhattan dermatologist Dennis Gross, MD. “Melanoma rates have increased along with air travel. Planes made it possible to dramatically change your latitude and the amount of sun your skin is exposed to in one day.”

A recent study of young Caucasian women—most of these studies are done on fair people because the lighter your skin, the more vulnerable you are to skin cancer—found that the wealthiest had the most exaggerated risk of melanoma. Disney princesses, take note: Fairest in the land? Living in a castle? Better go get a mole check, pronto! But it’s not just Gwyneth and Cinderella who are at risk: Melanoma rates have been increasing at nearly 3 percent a year among Hispanics. While only a small number of Asians and African-Americans get the disease—and their cases may be more related to a genetic glitch than to sun exposure—they’re often diagnosed only after the melanoma has metastasized, and their survival rate is thus significantly lower than it is for Caucasians.

 

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