While skin cancer may not be as common in African Americans as it is in other ethnicities, when melanoma is diagnosed it is usually at a later stage when survival rates are not as high. This is why the risk for melanoma is not something that should be ignored in African Americans.
Unfortunately, many patients and even some physicians are under the impression that non-Caucasian people are immune to skin cancer. That is one reason people of color are diagnosed with skin cancer at later stages. These delays mean that skin cancers are often advanced and potentially fatal, whereas most skin cancers are curable if caught and treated in a timely manner.
Most skin cancers are associated with ultraviolet (UV) radiation from the sun or tanning beds, and many people of color are less susceptible thanks to the greater amounts of melanin (the protective pigment that gives skin and eyes their color) darker skin produces. But people of color can still develop skin cancer from UV damage. According to the Skin Cancer Foundation, it comprises just 1 to 2 percent of all cancers among African Americans. But with less than half of melanomas in African Americans diagnosed at an early stage (compared to 74 percent in Hispanics and 84 percent in Caucasians) and survival rates hovering around 77 percent (versus 91 percent for Caucasians), it makes it a disease that still poses a high risk.
Additionally, certain skin cancers are caused by factors other than UV — such as genetics or other environmental influences — and may occur on parts of the body rarely exposed to the sun. For example, darker-skinned people are more susceptible to acral lentiginous melanoma (ALM), an especially dangerous form of melanoma that typically appears on the palms of the hands and soles of the feet. ALM can arise in skin that appears to be normal, and it can develop within a mole. It often starts as a slowly enlarging flat patch of discolored skin and is sometimes mistaken for a stain. At first, the malignant cells are found within the outermost layers of the skin, but the cancer later can become invasive. The thicker the melanoma, the more likely it is to metastasize and become life-threatening.
The most notable case of ALM in the black community is that of Reggae legend Bob Marley, who discovered a malignant melanoma under one of his toenails. The cancer spread to Marley’s lungs and brain causing his death in 1981 at the young age of 36.
Dermatologists stress that dark-skinned people should never be complacent about their risk for skin cancer. These experts recommend regular full-body examinations, just as for fair-skinned individuals, and urge them to be especially vigilant about routinely checking locations where ALM typically develops such as the soles of the feet and palms of the hands. Additionally, African Americans should follow Skin Cancer Foundation’s guidelines for sun protection by using a sunscreen with an SPF of 30 and wearing protective clothing when they are outdoors for extended periods.