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HomeBlogSkin cancer: shining a light on rising rates and lesser-known risks

Skin cancer: shining a light on rising rates and lesser-known risks

By: Medix Team
Skin cancer: shining a light on rising rates and lesser-known risks

Most of us know that prolonged exposure to ultraviolet (UV) radiation increases skin cancer risk and that darker skins enjoy better protection. But there are other risk factors too and these apply to all of us wherever we are.

One of the most successful public health awareness campaigns across the Western world in recent decades has been the one highlighting the dangers of skin cancer as a result of prolonged sun exposure. There are very few people who don’t realise that they need to wear sunscreen, cover up and avoid the midday sun particularly in hotter climates.


Whether they actually do so is still another matter. A recent US study forecast that the most deadly form of skin cancer, melanoma, would become the second most common cancer in the US by 2040, up from fourth currently.


That kind of incidence rate is applicable to all countries with light skinned populations. Yet the reality is that rates are rising everywhere.  


Researchers at the National University of Singapore reported that non-melanoma rates rose by almost 50% in the Lion City at the end of the 20th century. 

Rising figures are also evident in countries like India where the population has much stronger protection thanks to higher levels of the skin pigment melanin.  


One issue in countries with lower risk is lower awareness. This means that skin cancer is often not spotted soon enough.


There’s also lower awareness about where it appears on the body. Caucasians know to look out for suspicious moles and growths on parts of the body that have been exposed to the sun. On non-Caucasians, it’s often diagnosed in different areas, especially the periphery: hands, nails and feet, ears and nose. 


However, while skin cancer rates are forecast to rise, that doesn’t mean it has to become a reality.


There are diagnostic advancements, which could make analysis of skin lesions easier for primary care doctors who are not trained dermatologists. One of the most promising comes from Israel where researchers at Tel Aviv University have just developed a simple optical device using infrared light to distinguish between malignant and non-malignant skin lesions.


Greater awareness in lower risk countries should also help, since early detection and self-examination make a huge difference to prognosis.  The sun remains the main risk, but there are other too. Here are a few of the main ones scientists have discovered in recent years:


1. Testosterone


It’s already known that men diagnosed with prostate cancer have a higher risk of melanoma and vice versa. Recent studies suggest that testosterone may be a factor. An Oxford University study analysing UK data found a link between higher levels of testosterone in the blood and an increased risk of a melanoma. Each 50 picomoles increase in free testosterone raised the risk by 35%. Understanding the role the hormone plays is likely to be an important area for future research.


2. Blood pressure medication


Researchers from Canada’s University of Toronto are the latest to pinpoint a link between a certain type of blood pressure medication and skin cancer. 

The academics examined the health data of adults aged over 66, living in Ontario between 1988 and 2017. They found that those taking thiazide diuretics for longer than three years had a fourfold higher risk of developing a melanoma.


These findings build on previous warnings about the medication from the European Medicines Agency and US Food & Drug Administration (FDA). The drug is believed to interact with UV radiation to cause cellular damage. Other types of blood pressure medication have not been found to increase the risk.


3. Arsenic


Insecticides, pesticides and poultry feed that include arsenic will increase the skin cancer risk of the people who consume the end produce including it. Earlier this year, the Indian Institute of Technology in Kharagpur also estimated that about 20% of India’s total landmass has toxic levels of arsenic in its groundwater.


There’s also concern about rice consumption particularly among infants. In the US, for example, the FDA has just launched a Closer to Zero action plan to limit exposure in baby and infant food. Campaigners have previously highlighted that rice cereal has levels of inorganic arsenic that’s up to six times higher than other cereals such as oatmeal, quinoa or barley.



4. Citrus Fruits


We all know the benefits of eating citrus fruits like oranges and grapefruit. They provide a plentiful supply of vitamin C, which is good for the immune system. But they also contain a photoactive compound called furocoumarin, which may interact with UV radiation to cause skin cancer.


Researchers at Indiana University in the US published research based on a study of 56,205 Caucasian post-menopausal women in the UK. This showed that a single glass of orange juice per day, or one orange increased the risk.


Their findings may help doctors to give more nuanced guidance as part of better prevention strategies: suggesting a reduced intake for people with elevated risk factors such as a family history of skin cancer or prolonged sun exposure.


5. Genetics


One of the greatest advancements of the past few decades has been the ability to screen our DNA for mutations that increase the risk of developing certain cancers. One in ten people diagnosed with a melanoma will have an immediate family member with a history of the disease too.

One likely factor is changes to three tumour-suppressing genes called CDKN2A, BAP1 and MC1R. Alterations restrict their ability to control cell growth so that damaged cells cannot repair themselves so easily.


However, there’s also some good news. Rockefeller University researchers discovered that melanoma patients with a variant of a gene called APOE4 respond much better to immunotherapy. They also believe that this gene may stop cancer from spreading to other parts of the body.

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