Why Are so Many Women Still Getting Skin Cancer?

The surprising reasons--and a lifesaving guide to keep your body healthy this, and every, summer
by Shaun Dreisbach



Tesh Patel
Tesh Patel

Let's get the stats out of the way first--because they're shocking. Rates of melanoma, the deadliest form of skin cancer, have been rising in the United States, and no one has been more affected than young women. In the past few decades, the incidence of melanoma has shot up 800 percent among women ages 18 to 39, twice the rate of same-aged men. Says dermatologist David Kriegel, M.D., "I'm seeing three or four times more melanoma in young women than I used to." And the news on other skin cancers, like basal and squamous cell carcinomas, isn't much better: Rates have climbed 300 percent in the past decade.

The zillion-dollar question is: Why? Every girl and her cat knows the rules: You must wear (and reapply!) sunscreen, avoid prime sun hours, and cover up with shades and a hat. So why do skin cancer rates continue to soar? Our experts answer that very question. Don't miss their advice; it could save your skin--and your life.

1. Because we're just not that worried about skin cancer...and we should be

Deep down in our hearts, doctors sadly observe, most young women's attitude toward skin cancer is: So what? "I compare melanoma to what happened with lung cancer," says Len Lichtenfeld, M.D., deputy chief medical officer for the American Cancer Society. "Even after the surgeon general report on cigarettes came out in 1964, it took decades for people to really take the risks of smoking seriously. It's the same thing with skin cancer. People know the risks of sunburns and tanning, but they ignore them."

Guy's got a point. Today, after more than 20 years of awareness-raising, the percentage of women who apply sunscreen "always or most of the time" is only five points higher than it was a decade ago, and 63 percent admit to rarely, if ever, slathering on SPF, according to a Centers for Disease Control and Prevention survey. And despite the fact that getting five or more sunburns doubles your lifetime odds of melanoma, more than half of women say they've gotten at least one in the past year. "It's so disorienting to have a patient say, 'I love to tan. Do I have to wear sunscreen?' Yet I hear it a lot," says Ellen Marmur, M.D., founder of Marmur Medical in New York City. "It's as if we've made zero impact in some people's minds."

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And even if we do wear SPF, we kind of miss the point. "Young women often use sunscreen so they can hang out all day at the beach," says Elizabeth K. Hale, M.D., a clinical associate professor of dermatology at New York University School of Medicine. "They think they're being responsible and protecting themselves. But if you're out all day and not putting on and reapplying sunscreen every 40 to 80 minutes, you're really putting yourself at risk."

The fix:
Take skin cancer seriously, and remember, SPF is like a flak jacket: It protects you during the short times you need to be in the sun; it's not meant to allow you to stand in the line of fire all day. Throw on a cute sun hat, re-up on SPF 30 or higher every 40 minutes or so, and find some shade!

2. Because we need derms (not just docs)

At least three quarters of melanomas are discovered by patients themselves, according to the National Institutes of Health. (For advice on doing a self-check, click here.) But a good doctor might catch a suspicious spot before it has a chance to become cancerous, says Dr. Hale. "The other day I excised a premelanoma on the butt of a 30-year-old woman whose mole could have been less than a year away from turning cancerous," she says. "I can't imagine what might have happened had she not come in to see me. Early detection is so important." And the truth is, dermatologists are best at that early detection; primary care physicians are less skilled at spotting cancer--and less comfortable screening for it, researchers have found. All of which makes it scarier that only 8 percent of Americans have gotten a clinical skin exam by a dermatologist in the past year, and just 15 percent have had one ever, according to a study at the University of Miami.

The fix: See a dermatologist once a year, whether you've spotted a weird mole or not. "If there's nothing to find, the whole exam will take 10 minutes," says Dr. Marmur. Many health plans cover a skin check, but if insurance is an issue, you can find free clinics at aad.org.

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source: American Cancer Society; art by Glamour
source: American Cancer Society; art by Glamour

3. Because lots of us have tanning bed pasts (or presents!)
Indoor tanning is a Class 1 carcinogen, up there with cigarettes and arsenic; just one tanning session increases your lifetime risk of developing melanoma by 20 percent. So if you did it in the past, you must tell your derm: She may have you come in more frequently for skin checks, or she might biopsy a suspicious-looking mole rather than take a wait-and-see approach.

The fix:
Come clean about past baking. And if you're still hitting the tanning bed--one in every five women ages 18 to 29 does--for the love of George Hamilton, stop!

4. Because we're forgetting our family history

"A first-degree relative with melanoma is the most important risk factor for your getting melanoma, even more so that your past sun history," Dr. Hale says. Yet most people are very fuzzy on their family history. "When I ask patients if any of their immediate relatives has had skin cancer, they say 'I think my mom had a mole removed.' But they don't know what type, or if it even was cancer," says Dr. Kriegel, director of the Manhattan Center for Dermatology.

The fix: Quiz your parents before your exam. And share any past behaviors that might change the way your doc monitors your moles--e.g., that you used to lifeguard. "People don't bring things up, because they worry we'll judge them," Dr. Hale says. "But be honest, and we can talk about how to decrease your odds of skin cancer. The point is, we want you to have a healthy, active lifestyle--just be safe about it."

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