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More young people appear to be developing the most common types of skin cancer, a change that could herald a dramatic increase in the cost and suffering caused by the disease.
Mayo Clinic researchers studied only basal and squamous cell carcinomas, cancers that are almost always curable and that together afflict 1 million Americans a year, according to the article, published in today's Journal of the American Medical Association. The cancers, caused largely by overexposure to ultraviolet light from the sun, usually develop in older people who have spent many years outdoors.
In the study, doctors focused on people under 40 in Olmsted County, Minn. From 1976-1979 to 2000-2003, the combined rate of the two diseases grew from 19 cases per 100,000 people to 33 per 100,000 -- a 74% increase.
Although up to 90% of such cancers typically appear on the head and neck, doctors in the study found 40% of skin cancers on other parts of the body, a change that probably reflects the effect of excessive sunbathing.
Doctors studied the medical records of people in only one county, where most people are white. But researchers say their findings probably indicate an increased rate of skin cancer nationwide, at least among Caucasians, says the study's lead author, Leslie Christenson, a Mayo Clinic dermatologic surgeon.
The study suggests skin cancer could become a much larger public health problem in the decades ahead, says Darrell Rigel, former president of the American Academy of Dermatology. About half of people who develop a basal cell carcinoma develop at least one more, suggesting that these young people could be burdened by cancer for the next 30 to 40 years.
But H. Gilbert Welch, a researcher at the Department of Veterans Affairs in White River Junction, Vt., notes that the number of young people with skin cancer is still incredibly small.
"In people under 40, these cancers are rare as hens' teeth," Welch said in an e-mail. "The general public might reasonably wonder why we even call these abnormalities 'cancer.' No one died from these cancers in this study."
In an article published online last week in the British Medical Journal, Welch found that rates of melanoma -- a potentially deadly skin cancer -- are rising because doctors are screening more people for skin cancer, not because the disease is becoming more common.
Christenson says it's possible that some of the increase in basal and squamous cell carcinomas could be caused by increased screenings. But, she says, her findings suggest that tanning probably plays a more important role.
Basal and squamous cell carcinomas can be disfiguring, even if they rarely spread or turn fatal, Christenson says. And they kill about 1,000 to 2,000 people a year, the American Cancer Society says.
"For a preventable cancer, that's too bad," Christenson says.
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