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Utah worst in nation for melanoma skin cancer - Ogden Clinic provider source, Standard-Examiner 7/30/2014

(Standard-Examiner) OGDEN -- SALT LAKE CITY -- When it comes to deadly melanoma, Utah is the nation's leader, by far.

Recent data released by the Utah Department of Health on Tuesday show Utah's rate of new melanoma cases was 31.9 per 100,000 population between 2007 to 2011, significantly higher than the perpetually sunny states of Florida, Hawaii, California and Arizona. The Utah Cancer Registry shows the age-adjusted incidence rate of melanoma was 61 percent higher than the national rate between 2006 and 2010, with a mortality rate 30 percent higher. U.S. Acting Surgeon General Dr. Boris D. Lushniak has called on Americans to stem the tide of skin cancer by covering up and staying out of the sun.

People who live in areas with high elevation, warm climates, and where sunlight is reflected by sand, water, snow, and ice have a greater risk of developing melanoma, the deadliest type of skin cancer. Utah residents’ active outdoor lifestyles likely contribute to that risk.

“We know we can protect ourselves by wearing sunscreen and scheduling outdoor activities in the morning or late afternoon,” said Lynne Nilson, Director, UDOH Cancer Control Program. "As a state, however, we need to not only encourage these behaviors, but also make them easier by providing shade structures in public outdoor spaces, limiting the use of indoor tanning devices, and where possible making sunscreen available and accessible at worksites and outdoor venues," Nilson said.

The use of indoor tanning beds before age 35 also significantly increases a person's risk of developing melanoma. In 2011, more than one in 10 Utah students in grades 6 through 12 reported using an indoor tanning device at least once in the previous twelve months. After a 2012 regulation required a parent’s consent for a teen to use a tanning device, the rate dropped to approximately one in 14 the next year.

In addition to avoiding indoor tanning, practicing sun safe habits while outside can also help to prevent melanoma. These habits include properly applying sunscreen, staying out of the sun between 10 a.m. and 4 p.m. when the sun's ultraviolet rays are the strongest, seeking shade, wearing sunglasses and hats with a wide brim, and wearing pants or long skirts and shirts with long sleeves.

Dr. Chad Tingey, an Ogden Clinic dermatologist said as someone who is seeing individual cancer patients on “the frontline” of diagnosis and treatment, it’s exciting to get this kind of recommendation from the top.

“We here in our corner of the world clearly see more and more skin cancers, younger and younger aged patients, and unfortunately more aggressive melanomas and skin cancers,” Tingey said. “There is clearly a link to sun and indoor tanning in the patients we see. We can help catch the lesions earlier and treat when cure is possible, but it helps to have patients be aware to avoid and prevent the tumors in the first place. We just saw a young 30 year-old woman who has tanned indoors for years with an aggressive melanoma on her foot that I wish could have been avoided. Maybe this kind of information will help the future of these cancers.”

Dr. Scott R. Checketts, a dermatologist at Tanner Clinic in Layton said he has seen about 10 cases of melanoma a year since 2009.

“I don’t have an explanation as to why the rate of melanoma is so high in Utah right now but elevation is absolutely a factor. Most people in Utah are of northern European decent so we have fair complexions,” he said. “There’s also really only two months of the year when it’s cloudy enough to block ultraviolet light.”

Checketts said along with that, he has seen moms who have gotten really good about protecting their children better than themselves. “If you go to Lagoon or Cherry Hill, they are lathering their kids with sunscreen,” he said. “Our melanoma education has improved and people are catching cancerous moles faster. More are being caught in the stage one category, which is an improvement. We don’t know the demographics of those numbers, but out of 10 cases of melanoma I see a year, the average person is 50 years old.”

Checketts, who is not a fan of tanning beds said he suspects Utah’s numbers will continue to go down over the next 10 to 20 years because of the state’s strong stance on tanning beds making it harder for young people to access them. While he can recommend people stay out of the sun between 10 a.m. and 4 p.m., he said it’s always high noon inside a tanning bed.

Tingey agrees and said using indoor tanning is like drinking concentrated orange juice without mixing in the three cans of water.

In addition to avoiding indoor tanning, practicing sun safe habits while outside can also help to prevent melanoma. These habits include properly applying sunscreen, staying out of the sun between 10 a.m. and 4 p.m. when the sun’s ultraviolet rays are the strongest, seeking shade, wearing sunglasses and hats with a wide brim, and wearing pants or long skirts and shirts with long sleeves.

Checketts and Tingey said advances in skin cancer treatment have improved greatly over the years. One of those procedures is called Mohs. Named after Dr. Fred Mohs, the procedure is an ideal approach to many skin cancers.

“It involves removing the tumor, mapping and color coding it, and then looking for extensions of the tumor under the skin. Older methods of removing the skin with a healthy margins of tissue around it showed the tumor would grow back in 10 to 15 percent of the patients – not cool if it’s your nose,” Tingey said. “Mohs has less than 0.1 percent grow back, and leaves a smaller wound on the patient. Smaller hole, higher cure rate. It’s really a miraculous procedure.

In recent years, members of the state’s comprehensive cancer coalition, the Utah Cancer Action Network (UCAN), have worked to increase sun safety habits among Utahns by collaborating with a variety of outdoor recreation facilities on sun safety education programs, hosting free skin cancer screening events, and providing education in schools.

http://www.standard.net/News/2014/07/29/Utah-worst-in-nation-for-melanoma-skin-cancer.html