New Risk Factors for Malignant Melanoma Skin Cancer

We have all known that fair skinned people, as well as sunburn and cumulative lifelong sun exposure, increases a person’s risk of skin cancers and particularly malignant melanoma.

Melanoma is the dark or black skin cancer that has the potential to spread throughout the body and cause death. Another risk factor for Melanoma includes people with a family history of malignant melanoma and those who have dysplastic naevus syndrome.

Dysplastic Naevus Syndrome is a condition where there are numerous moles that are of different shapes, sizes and colours. Some are flat, and some are raised. They can be pale pink, or as deep as the darkest brown. They tend to occur mostly on the trunk, but also on upper arms and thighs. These people look like Dalmation dogs with the various coloured spots on them.

On 5 March, at a meeting of the American Academy of Dermatology, Professor Darrell Rigel, dermatologist, presented some new research that added a few more risk factors for all of us to be aware of. He studied 600 people – 300 with malignant melanoma and 300 without, and studied 43 risk factors. He came to the conclusion that there were six risk factors that were significant and increased a person’s risk of malignant melanoma.

Those risk factors are:

• A history of blistering sunburns as a teenager.
• Red or blonde hair.
• Marked freckling of the upper back – a sign of excessive sun exposure and that this person is susceptible to Melanoma.
• Family history of melanoma.
• History of solar keratoses (pre-malignant scaly areas that your family doctor treats with liquid nitrogen) – considered the earliest stage in the development of a skin cancer.
• Outdoor summer jobs for 3 or more years as a teenager.

Professor Rigel said that if you have one of these six risk factors your melanoma risk doubles or triples compared with the general population. If you have two or more of these factors, the risk multiplies by 5-10 times compared with the population. Anyone with three or more of these six factors have up to 10-20 times increased risk of developing a melanoma.

Professor Rigel also presented other conditions that have an association with malignant melanoma and they are:

• Women or men with a previous history of breast cancer, have a 2-3 times higher risk of developing melanoma.
• Women with a past history of thyroid cancer have a doubled risk of developing melanoma.
• A higher socio-economic class increases the risk, presumably because they can afford more holidays and leisure time that puts them into the sun.
• Airline flight personnel have a higher rate of melanoma when compared with other occupations.
• Male drivers have a higher incidence of skin cancer on the right side of their body compared with the left side of their body.
• Taller men are found to have a higher rate of melanoma than shorter men – the tall men in the top 25% have twice the likelihood of developing melanoma compared with those in the bottom 25% of height.
• The use of tanning beds is a major risk factor for melanoma. Those who use tanning beds have a higher risk of melanoma, with a higher risk of getting a second melanoma and are also younger when they develop it.
• Those with a history of dysplastic naevi and a family history of melanoma have a 50% greater risk of developing melanoma.

So, the take home message here is to watch out for certain things:

• Sunburn at any time of life is risky.
• Family history of malignant melanoma.
• Dysplastic naevi.
• Malignant melanoma has an association with breast and thyroid cancer.
• An association with certain occupations, e.g. airline flight personnel and those exposed to sunlight in their occupation.

Anyone with a family member who has had a malignant melanoma should have their skin checked yearly. Any new or suspicious mole should be checked immediately by a doctor.

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