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Skin cancer


Incidence rates

  • Skin cancer is the most common cancer in the United States.1-2

  • Current estimates are that one in five Americans will develop skin cancer in their lifetime.3-4

  • It is estimated that approximately 9,500 people in the U.S. are diagnosed with skin cancer every day.5-7

  • Research estimates that nonmelanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), affects more than 3 million Americans a year.5, 8

  • Research indicates that the overall incidence of BCC increased by 145% between 1976-1984 and 2000-2010, and the overall incidence of SCC increased 263% over that same period.9

    • Women had the greatest increase in incidence rates for both types of NMSC.9

  • More than 1 million Americans are living with melanoma.10

  • It is estimated that 196,060 new cases of melanoma, 95,710 noninvasive (in situ) and 100,350 invasive, will be diagnosed in the U.S. in 2020.6-7

    • Invasive melanoma is projected to be the fifth most common cancer for men (60,190 cases) and sixth most common cancer for women (40,160 cases) in 2020.6-7

  • Melanoma rates in the United States have been rising rapidly over the past 30 years — doubling from 1982 to 2011 — but trends within the past decade vary by age.1, 7

    • Melanoma incidence has begun to decline in adolescents and adults ages 30 and younger. By contrast, melanoma incidence increased among older age groups, with more pronounced increases in people ages 80 and older.45-46

  • Caucasians and men older than 50 have a higher risk of developing melanoma than the general population.6-7, 11

    • The annual incidence rate of melanoma in non-Hispanic Caucasians is 28 per 100,000, compared to 5 per 100,000 in Hispanics and 1 per 100,000 in African Americans.6

  • Skin cancer can affect anyone, regardless of skin color.

    • Skin cancer in patients with skin of color is often diagnosed in its later stages, when it’s more difficult to treat.12

      • Research has shown that patients with skin of color are less likely than Caucasian patients to survive melanoma.13

      • Twenty-four percent of melanoma cases in African American patients are diagnosed when the cancer has spread to nearby lymph nodes, while 16% are diagnosed when the cancer has spread to distant lymph nodes and other organs.7

    • People with skin of color are prone to skin cancer in areas that aren’t commonly exposed to the sun, like the palms of the hands, the soles of the feet, the groin and the inside of the mouth. They also may develop melanoma under their nails.12

  • Before age 50, melanoma incidence rates are higher in women than in men; however, rates in men are twice as high by age 65 and almost three times as high by age 80.6

    • It is estimated that melanoma will affect 1 in 28 men and 1 in 41 women in their lifetime.7

  • Melanoma is the second most common form of cancer in females age 15-29.14

    • Melanoma incidence is higher in females than in males in younger age groups, though incidence rates in younger age groups overall have shown declines in recent years.45-46

Survival rates

  • Basal cell and squamous cell carcinomas, the two most common forms of skin cancer, are highly treatable if detected early and treated properly.6,17

  • The five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 92%.6-7

  • The five-year survival rate for melanoma that spreads to nearby lymph nodes is 65%. The five-year survival rate for melanoma that spreads to distant lymph nodes and other organs is 25%.6-7

Mortality rates

  • The vast majority of skin cancer deaths are from melanoma.6

  • Nearly 20 Americans die from melanoma every day. In 2020, it is estimated that 6,850 deaths will be attributed to melanoma — 4,610 men and 2,240 women.6-7

  • Research indicates that men diagnosed with melanoma between the ages of 15 and 39 were 55% more likely to die from melanoma than females diagnosed with melanoma in the same age group.18

  • Research indicates that men with melanoma generally have lower survival rates than women with melanoma, which experts estimate may be attributable to skin differences and disparate sun protection practices.47-48

  • Overall melanoma death rates drastically declined between 2013 and 2017, specifically by 7% annually in adults younger than 50 and by 5.7% annually in older adults. The older age group’s melanoma mortality rates had been increasing prior to 2013.6-7

  • People with SCC have a higher risk of death from any cause than the general population.19

  • An estimated 4,630 deaths from skin cancers other than melanoma and NMSC are expected to occur in the United States in 2020.6-7

Risk factors

  • Exposure to natural and artificial ultraviolet light is a risk factor for all types of skin cancer, including melanoma, the deadliest form.6

  • The majority of melanoma cases are attributable to UV exposure.20-22

  • Increasing intermittent sun exposure in childhood and during one’s lifetime is associated with an increased risk of squamous cell carcinoma, basal cell carcinoma and melanoma.23

  • Research suggests that regular sunscreen use with an SPF of 15 or higher reduces melanoma risk.24-25

    • Higher melanoma rates among men may be due in part to lower rates of sun protection.1, 26

  • Sunburns during childhood or adolescence can increase the odds of developing melanoma later in life.27

    • Experiencing five or more blistering sunburns between ages 15 and 20 increases one’s melanoma risk by 80% and nonmelanoma skin cancer risk by 68%.28

  • Exposure to tanning beds increases the risk of all skin cancers, including melanoma, especially in women 45 and younger.29-30

    • Researchers estimate that indoor tanning may cause upwards of 400,000 cases of skin cancer in the U.S. each year.31

  • Risk factors for all types of skin cancer include skin that burns easily; blond or red hair; a history of excessive sun exposure, including sunburns; tanning bed use; a weakened immune system; and a history of skin cancer.6

    • People with more than 50 moles, atypical moles or large moles are at an increased risk of developing melanoma, as are those as are sun-sensitive individuals (e.g., those who sunburn easily, or have natural blond or red hair) and those with a personal or family history of melanoma.6, 33

  • Melanoma survivors have an approximately nine-fold increased risk of developing another melanoma compared to the general population.34

  • Men and women with a history of nonmelanoma skin cancer are at a higher risk of developing melanoma than people without a nonmelanoma skin cancer history.35

    • Women with a history of nonmelanoma skin cancer are at a higher risk of developing breast and lung cancers.35

  • Caucasian individuals who have had more than one melanoma have an increased risk of developing both subsequent melanomas and other cancers, including those of the breast, prostate and thyroid.36

Prevention and detection

  • Because exposure to UV light is the most preventable risk factor for all skin cancers, the American Academy of Dermatology encourages everyone to stay out of indoor tanning beds and protect their skin from the sun’s harmful UV rays by seeking shade, wearing protective clothing and using a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher.

    • Because severe sunburns during childhood and adolescence may increase one’s risk of melanoma, children should be especially protected from the sun.6

  • Skin cancer warning signs include changes in size, shape, or color of a mole or other skin lesion, the appearance of a new growth on the skin, or a sore that doesn't heal. If you notice any spots on your skin that are different from the others, or anything changing, itching or bleeding, the American Academy of Dermatology recommends that you make an appointment with a board-certified dermatologist.

  • The American Academy of Dermatology encourages everyone to perform regular skin self-exams to check for signs of skin cancer.

    • About half of melanomas are self-detected.37-41

  • A dermatologist can make individual recommendations as to how often a person needs a skin exam from a doctor based on individual risk factors, including skin type, history of sun exposure and family history.

  • Individuals with a history of melanoma should have a full-body exam by a board-certified dermatologist at least annually and perform regular self-exams to check for new and changing moles.42

Cost

  • About 4.9 million U.S. adults were treated for skin cancer each year from 2007 to 2011, for an average annual treatment cost of $8.1 billion.2

    • This represents an increase over the period from 2002 to 2006, when about 3.4 million adults were treated for skin cancer each year, for an annual average treatment cost of $3.6 billion.2

  • The annual cost of treating nonmelanoma skin cancer in the U.S. is estimated at $4.8 billion, while the average annual cost of treating melanoma is estimated at $3.3 billion.2

  • Researchers estimate that there were nearly 34,000 U.S. emergency department visits related to sunburn in 2013, for an estimated total cost of $11.2 million.43

Related AAD resources


1Guy GP, Thomas CC, Thompson T, Watson M, Massetti GM, Richardson LC. Vital signs: Melanoma incidence and mortality trends and projections—United States, 1982–2030. MMWR Morb Mortal Wkly Rep. 2015;64(21):591-596.

2Guy GP, Machlin S, Ekwueme DU, Yabroff KR. Prevalence and costs of skin cancer treatment in the US, 2002–2006 and 2007–2011. Am J Prev Med. 2015;48:183–7.

3Stern RS. Prevalence of a history of skin cancer in 2007: results of an incidence-based model. Arch Dermatol. 2010 Mar;146(3):279-82.

4Robinson JK. Sun Exposure, Sun Protection, and Vitamin D. JAMA 2005; 294: 1541-43.

5Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population. JAMA Dermatol. Published online April 30, 2015.

6American Cancer Society. Cancer Facts & Figures 2020. Atlanta: American Cancer Society; 2020.

7Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020; doi: 10.3322/caac.21590.

8American Academy of Dermatology/Milliman. Burden of Skin Disease. 2017. www.aad.org/BSD.

9Muzic, JG et al. Incidence and Trends of Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma: A Population-Based Study in Olmstead County, Minnesota, 2000-2010. Mayo Clin Proc. Published Online May 15, 2017. http://dx.doi.org/10.1016/j.mayocp.2017.02.015

10SEER Cancer Stat Facts: Melanoma of the Skin. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/melan.html

11Little EG, Eide MJ. Update on the current state of melanoma incidence. Dermatol Clin. 2012:30(3):355-61.

12Agbai ON, Buster K, Sanchez M, Hernandez C, Kundu RV, Chiu M, Roberts WE, Draelos ZD, Bhushan R, Taylor SC, Lim HW. Skin cancer and photoprotection in people of color: a review and recommendations for physicians and the public. J Am Acad Dermatol. 2014;70(4):748-62.

13Dawes SM et al. Racial disparities in melanoma survival. J Am Acad Dermatol. 2016 Nov; 75(5):983-991.

14Surveillance, Epidemiology, and End Results (SEER) program 18 registries. Data run July 25, 2018.

15Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/, based on November 2017 SEER data submission, posted to the SEER web site, April 2018.

16Reed KB et al. Increasing Incidence of Melanoma among Young Adults: An Epidemiological Study in Olmsted County, Minnesota. Mayo Clinic Proceedings, 2012; 87 (4): 328–334.

17Neville JA, Welch E, Leffell DJ. Management of nonmelanoma skin cancer in 2007. Nat Clin Pract Oncol 2007; 4(8):462-9.

18Gamba CS, Clarke CA, Keegan TM, et al. Melanoma Survival Disadvantage in Young, Non-Hispanic White Males Compared With Females. JAMA Dermatol. 2013;149(8):912-920. doi:10.1001/jamadermatol.2013.4408

19Wehner MR et al. All-cause mortality in patients with basal and squamous cell carcinoma: A systematic review and meta-analysis. Journal of the American Academy of Dermatology. 2018: 78 (4): 663 - 672.e3.

20Arnold M, Kvaskoff M, Thuret A, Guenel P, Bray F and Soerjomatarm I. Cutaneous melanoma in France in 2015 attributable to solar ultraviolet radiation and the use of sunbeds. J Eur Acad Dermatol Venereol. Published online April 16, 2018. https://doi.org/10.1111/jdv.15022

21Arnold M et al. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int J Cancer. 2018 April. https://doi.org/10.1002/ijc.31527.

22Parkin DM, Mesher D and Sasieni P. Cancers attributable to solar (ultraviolet) radiation exposure in the UK in 2010. British Journal of Cancer. 2011. 105 (S66–S69) doi: 10.1038/bjc.2011.486.

23Lin JS, Eder M, Weinmann S. Behavioral counseling to prevent skin cancer: asystematic review for the U.S. Preventive Services Task Force. Ann Intern Med.2011 Feb 1;154(3):190-201. Review.

24Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up J Clin Oncol Jan 20, 2011:257-263; published online on December 6, 2010.

25Watts CG, Drummond M, Goumas C, et al. Sunscreen Use and Melanoma Risk Among Young Australian Adults. JAMA Dermatol. Published online July 18, 2018. doi:10.1001/jamadermatol.2018.1774

26CDC. Sunburn and sun protective behaviors among adults aged 18–29 years—United States, 2000–2010. MMWR Morb Mortal Wkly Rep 2012;61:317–22.

27Dennis, Leslie K. et al. “Sunburns and Risk of Cutaneous Melanoma, Does Age Matter: A Comprehensive MetaAnalysis.” Annals of epidemiology 18.8 (2008): 614–627.

28Wu S, Han J, Laden F, Qureshi AA. Long-term ultraviolet flux, other potential risk factors, and skin cancer risk: a cohort study. Cancer Epidemiol Biomar Prev; 2014. 23(6); 1080-1089.

29Ting W, Schultz K, Cac NN, Peterson M, Walling HW. Tanning bed exposure increases the risk of malignant melanoma. Int J Dermatol. 2007 Dec;46(12):1253-7.

30Colantonio S, Bracken MB, Beecker J. The association of indoor tanning and melanoma in adults: systematic review and meta-analysis. J Am Acad Dermatol 2014;70:847–57.

31Wehner M, Chren M-M, Nameth D, et al. International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol 2014; 150(4):390-400. Doi: 10.1001/jamadermatol.2013.6896.

32Wehner MR, Shive ML, Chren MM, Han J, Qureshi AA, Linos E. Indoor tanning and non-melanoma skin cancer: systematic review and meta-analysis. BMJ. 2012 Oct 2;345:e5909.

33Gandini S, Sera F, Cattaruzza MS, Pasquini P, Picconi O, Boyle P, Melchi CF. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer. 2005 Jan;41(1):45-60.

34Bradford PT, Freedman DM, Goldstein AM, Tucker MA. Increased risk of second primary cancers after a diagnosis of melanoma. Arch Dermatol. 2010 Mar;146(3):265-72.

35Song F, Qureshi AA, Giovannucci EL, et al. (2013) Risk of a Second Primary Cancer after Non-melanoma Skin Cancer in White Men and Women: A Prospective Cohort Study. PLoS Med 10(4): e1001433. doi:10.1371/journal.pmed.1001433

36Cai ED, Swetter SM and Sarin KY. Association of multiple primary melanomas with malignancy risk: a population-based analysis of the Surveillance, Epidemiology, and End Results Program database from 1973-2014. Journal of the American Academy of Dermatology. Published online Oct. 1, 2018. https://doi.org/10.1016/j.jaad.2018.09.027

37Avilés-Izquierdo JA, Molina-López I, Rodríguez-Lomba E, Marquez-Rodas I, Suarez-Fernandez R, Lazaro-Ochaita P. Who detects melanoma? Impact of detection patterns on characteristics and prognosis of patients with melanoma. J Am Acad Dermatol. 2016; 75(5):967-974.

38Cheng MY, Moreau JF, McGuire ST, Ho J, Ferris LK. Melanoma depth in patients with an established dermatologist. Journal of the American Academy of Dermatology. 2014; 70(5):841-846.

39Brady MS, Oliveria SA, Christos PJ, et al. Patterns of detection in patients with cutaneous melanoma. Cancer. 2000;89:342-347.

40Epstein DS, Lange JR, Gruber SB, et al. Is Physician Detection Associated With Thinner Melanomas? JAMA. 1999;281(7):640-643.

41Koh HK, Miller DR, Geller AC, et al. Who discovers melanoma? Patterns from a population-based survey. Journal of the American Academy of Dermatology. 1992;26:914-919.

42Berg A. Screening for skin cancer. US Preventive Services Task Force, 2007.

43Guy GP, Berkowitz Z and Watson M. Estimated Cost of Sunburn-Associated Visits to US Hospital Emergency Departments. JAMA Dermatology 2017.153 (1): 90-92.

44Ward E, Sherman RL, Henley SJ, Jemal A, Siegel DA, Feuer EJ, Firth AU, Kohler BA, Scott S, Ma J, Anderson RN. Annual Report to the Nation on the Status of Cancer, 1999–2015, Featuring Cancer in Men and Women ages 20–49. J Natl Cancer Inst. Published online May 30, 2019.

45Thrift AP, Gudenkauf FJ. Melanoma incidence among non-Hispanic whites in all 50 US states from 2001 through 2015. J Natl Cancer Inst 2019 doi:10.1093/jnci/djz153

46Paulson KG, Gupta D, Kim TS. Age-Specific Incidence of Melanoma in the United States. JAMA Dermatol 2020;156(1):57-64. doi:10.1001jamadermatol.2019.3353

47Sharouni MA, Witkamp AJ, Sigurdsson V, van Diest PJ, Louwman MWJ, Kukutsch NA. Sex matters: men with melanoma have a worse prognosis than women. Journal of the European Academy of Dermatology and Venereology 2019 doi:10.1111/jdv.15760

48Gamba CS, Clarke CA, et al. Melanoma survival disadvantage in young, non-Hispanic white males compared with females. JAMA Dermatology 2013;149(8):912-20