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If you have light-colored skin and blue or green eyes, your risk of skin cancer is higher than if you have darker skin and brown eyes. However, people with skin of color (a term that is defined in the column "Skin Cancer and Skin of Color," on page 70) have a much higher risk of death from skin cancer than others. This isn't meant to be alarmist; it's meant to point out the importance of knowledge and vigilance against this highly treatable, highly survivable disease. The statistics about skin cancer are surprisingly difficult to gather, especially about NMSC, which is to say, basal and cutaneous squamous cell carcinoma. This is at least partly because we have no national reporting guidelines, and it is impossible to guess how many of the skin lesions that are removed or burned off "just in case" may or may not have been cancerous. One of the consequences of this is that different organizations report different numbers about NMSC diagnoses and deaths. These statistics get even more complicated when we consider sex and ethnicity. For instance, men get skin cancer more often than women, probably because, as a whole, they spend more time working outside. 1 But cases of NMSC among aff luent Black women are rising—possibly because they are likely to engage in more outdoor activities like tennis, golf, and gardening. Here is a summary of what we know (or think we know) about how common and how threatening various types of skin cancer are. First, the risk of skin cancer is not evenly distributed across populations. It accounts for about: • 45 percent of cancers in White people • 5 percent of cancers in Hispanic people • 4 percent of cancers in Asian people • 2 percent of cancers in Black people However, it is more likely to be found after significant growth or metastasis in people of color, compared to non- Hispanic White people. Basal Cell Carcinoma (BCC) BCC is the most common kind of skin cancer among White, Hispanic, and East Asian people. It's hard to determine how many cases of BCC are identified each year in this country, but some estimates suggest about 5.4 million cases of NMSC are treated annually, and about 80 percent of those are BCC: over 4 million cases. 2 BCC almost never metastasizes, so its survival rate is very high. L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 35 Cutaneous Squamous Cell Carcinoma (cSCC) Statistics for cSCC vary by skin tone. It is the most common kind of skin cancer for people with darker skin, especially for African Americans and people of East Indian descent, and the second most common kind for light-skinned people, specifically Whites, Hispanics, and Asian Americans. This type of cancer accounts for about 20 percent of all NMSC, with an estimated 1 million diagnoses every year in this country. And while organizations vary on the mortality rate of cSCC, at least one reputable source suggests that over 15,000 people die of this disease in the US each year. Many of these patients are elderly, and many may be immune compromised; immune suppression is a contributing factor for cSCC. But it's also relevant to point out that cSCC is 10 times more likely to metastasize in Black people compared to White people. 3 That's not because it's more aggressive in Black people; it's because delays in diagnosis and treatment lead to poorer outcomes. The mortality rate of cSCC is a surprising statistic—if the estimate of 15,000 deaths per year is accurate, then cSCC takes twice as many lives each year as melanoma. Melanoma Melanoma is the least common form of skin cancer, but it metastasizes easier than all other types. Statistics suggest that anywhere from 100,000 to 200,000 cases are treated, and about 7,500 deaths are attributed to melanoma each year in the US. 4 If it's found early, melanoma is highly treatable and has an excellent survival rate—if the patient is White. The five-year survival rate for melanoma in White people is 93 percent; in Black people it's 71 percent. The Pathology Perspectives column "Skin Cancer and Skin of Color" (page 70) offers more discussion of disparities in skin cancer diagnoses and outcomes. NEW CE COURSE BY RUTH WERNER: "SKIN CANCER: BEYOND THE BASICS" 1. Open your camera 2. Scan the code 3. Tap on notification 4. Learn!