Do Black People Get Skin Cancer? What Is Their Prognosis?

Cancer which starts in the skin is skin cancer as it originates in the skin and it is one of the common forms of cancer affecting the Americans ⁽¹⁾. Melanoma is the most serious type of skin cancers amongst the various skin cancers.

Having a lighter or white skin tone is a potential risk factor for developing skin cancer ⁽¹⁾. However, it is important to bear in mind that anyone from any skin of color can have skin cancer including black skin.

In this article, we will talk about skin cancer occurring on black skin, how to diagnose it and ways to prevent it.

Can Black People Get Skin Cancer?

Yes, skin cancer can develop in black people also, as they too are also exposed to the same risk factors, such as ultraviolet rays, as other people from different ethnicities and races. Generally speaking, skin cancer is seen less in Black people. According to the Centers for Disease Control and Prevention (CDC), it was found that in the year 2018, there was 1 case of melanoma in 100,000 Black people when compared to 25 cases in 100,000 white people ⁽²⁾.

What Makes Black People Less Susceptible To Skin Cancer?

To understand the reason of skin cancer occurring lesser in Black people, one needs to understand the biology of the skin. Everyone’s skin contains a melanin, which is a pigment. However, in comparison to white skin, there is increased melanin present in black skin.

Increased amounts of melanin reflect or absorb more UV rays from the sun, and this helps in better protection of the cells from any harm. As the melanin is present in lesser quantities in white people, the protection is also less making them more susceptible to damage from the UV rays.

What Are The Risks Linked With Skin Cancer In Black People?

Black skinned individuals who perceive their skin cancer risk as low may not seek care for skin changes, which can be potentially cancerous.

A study from 2018 where focus groups were used to assess Latino and Black people’s knowledge regarding skin cancer and it was found that ⁽³⁾:

There were participants who thought they had a low risk for getting skin cancer due to their darker skin tone or not having family history of skin cancer.

Black participants also reported symptoms of skin cancer in an inconsistent manner than participants who were Latino.

Skin cancer when diagnosed at a later stage makes it more difficult to treat.  

Most of the times, in black people skin cancer is diagnosed at its later stages. According to the American Academy of Dermatology, around 25% of melanomas in Black people are diagnosed after it had metastasized to the adjacent lymph nodes ⁽⁴⁾.

What Are The Chances Of Other People Of Color To Get Skin Cancer?

Yes, other People of color can also develop skin cancer and the risk factors are same as others. The rate of skin cancer in other People of Color, when compared to white people is less; however, it is more than Black people. 

What Are The Causes For Skin Cancer In Black People?

The exact cause of cancer is not clear. It is thought that skin cancer occurs as a result of genetic changes happening in the DNA of the cells. These changes can cause the cells to grow and multiply rapidly out of control.

Damage to the DNA can occur from UV radiation from the sun. However, not all skin cancers are related to sun exposure. There are some skin cancers occurring in black people in areas which do not get any sun exposure, such as palms of the hands, soles of the feet and nails. This form of skin cancer is known as acral lentiginous melanoma (ALM). According to experts ALM comprises of 30 to 70% melanomas occurring in People of Color ⁽⁵⁾.

The exact cause of acral lentiginous melanoma is not known. However, genetic factors are thought to play a role in the development of this condition.

What are the Symptoms of Skin Cancer in Black people?

The primary symptom of skin cancer is changes to the skin area. Not all the skin cancers look the same and a cancerous area can have one or more of the following characteristics given below.

Location: Skin cancer tends to develop on the parts of the body which frequently get sun exposure. Some of the examples of these areas are: ears, face, scalp, shoulders, neck, chest, hands and arms. Skin cancer on black skin also has a tendency to develop on certain areas of the body and this consists of: soles of the feet, palms, lower legs, groin, beneath the toenail or fingernail.

Skin cancer can develop anywhere in the body and if there is an area of concern, then it is imperative to consult a dermatologist.

Shape: Cancerous moles or spots are usually different in shape than other moles and spots on the body. Cancerous lesions will have asymmetrical or irregular shape and will have a jagged border or outline.

Color: An area affected by cancer will have a different color when compared to the surrounding skin and it is usually darker. On individuals with black skin, the cancerous lesions can appear as: purple, dark brown, black and ashen gray.

Another thing to look out for with spots or moles is color distribution. A cancerous spot or mole will likely have uneven color present, such as some areas can be lighter or darker than others.

Size: In some forms of skin cancer, like melanoma, the mole or spot can be large in size. A way to look for it is whether the size of the suspicious lesion is bigger than the size of a pea ⁽⁶⁾.

Texture: Skin cancers, such as squamous and basal cell carcinoma can develop as a patch that feels dry, rough or scaly when compared to the adjacent skin.

Bleeding: The chances of bleeding occurring from the cancerous lesion are high.

Evolution:  Skin cancer often changes with time, such as the concerned skin area with time can increase in size or can form into an ulcer, which does not heal or recurs.

How is Skin Cancer Diagnosed?

Dermatologist is a doctor specializing in skin and skin conditions and will diagnose the skin cancer. The patient’s medical history will be taken and then a physical exam will be done. The physical exam of the skin will be conducted where the dermatologist checks the skin for any bumps or spots that look abnormal. In case an area is found that looks different in color, shape or size, then a biopsy is taken where a part of the lesion or the entire lesion is carefully removed and sent to lab for testing for abnormal cells.

What is the Treatment for Skin Cancer?

Overall, the treatment that’s recommended for skin cancer depends on factors like the type of cancer, its stage and where it’s located on your body.

Treatment for skin cancer consists of surgery where different types of procedure are done to include:

Excision is done using a small blade to cut out the affected region.

Cryosurgery is a procedure where a special instrument is used to freeze and kill the cancerous cells in the affected part.

Curettage and electrodesiccation can be done where a sharp tool known as curette is used to remove the cancerous part after which with the help of a tool which produces electric current is used to burn and destroy the remaining cancer cells and to stop the bleeding.

Mohs surgery is done for the purpose of removing as less tissue as possible.  This procedure is usually done for areas, such as face, fingers and genitals. In this procedure, there is removal of small tissue layers and each layer is then checked under the microscope for malignant cells until a clean layer with no cancer cells is obtained.

Instead of surgery other treatments that can be used especially if the cancer has spread in the body include:

Chemotherapy is another cancer treatment where strong drugs are used to kill the cancer cells or delay their growth.

Radiation therapy where high-energy radiation is used to destroy the cancer cells or halt them from further growth.

Immunotherapy is a type of cancer treatment, which works by aiding the immune system in identifying and destroying the cancer cells.

Targeted therapy is aimed at specific molecules which are present in cancer cells. This mode of cancer treatment causes less damage to the healthy tissue when compared to chemotherapy or radiation therapy. 

Are There Any Sources Specific To Skin Cancer For Black People?

Various resources are there which are focused on black skin and provide help and care:

• American Academy of Dermatology has a search tool which helps in finding a board certified dermatologist where the patient is living.
• Black Derm Directory is a resource which helps in looking for dermatologist who specializes in conditions that affect black skin ⁽⁷⁾.
• Skin of Color Society aims to increase awareness and increase excellence in dermatology for people of skin of color.

Is There Any Way to Prevent Skin Cancer in Black people?

The following steps are helpful in preventing skin cancer:

• Exposure to UV rays is one of the primary causes of many types of skin cancer. For this reason it is important to stay out of direct sunlight when going outside.
• Always avoid going outside when the sun is at its highest and strongest which include the timings from 10 a.m. to 4 p.m.
• Sunscreen is non-negotiable when stepping out in the sun. Some things to look for in a sunscreen are:
• Use a sweat or water-resistant sunscreen having an SPF of 30 or more.
• Always apply your sunscreen around 15 to 20 minutes before stepping outside, which allows the cream to soak into the skin.
• Remember to apply sunscreen on areas such as top of the ears, feet and nape of the neck.
• Always reapply your sunscreen every two hours; more so after swimming or sweating.
• Wear clothes which offer more protection or act as a physical barrier such as hats, scarves, goggles, full sleeves shirt and pants for extra protection from the sun.
• Make skin checks regularly where you should look for any suspicious bumps or spots which are abnormal in size, color or shape. 

What’s the Prognosis for Skin Cancer in Black People?

In Black skinned people, skin cancer is usually diagnosed in its later stages, which makes the outlook not that good.

A study from 2019, where melanoma in Black Americans was studied; and it was found that the 5-year survival rate for melanoma was around 66.2 percent for Black Americans, when compared to about 90.1 percent in white Americans ⁽⁸⁾. The cause for late diagnosis can occur due to different reasons, such as:

• Not using sun protection regularly.
• Less awareness about skin cancer signs and symptoms.
• Not having equal access to healthcare.

The outlook or the prognosis for skin cancer or any cancer is better when it is detected and treated early. Many of the skin cancers, including melanoma, can be cured when detected in the early stage.

It is important to take steps to prevent skin cancer in the first place irrespective of the skin color. It is recommended to perform regular skin checks, using sunscreen, protecting yourself from sun exposure by using additional physical barriers in the form of hats, long sleeves, pants etc.

Conclusion

Black skinned people when compared to lighter skin are at lesser risk for skin cancer; and this makes them more complacent where the skin cancer is often diagnosed at a later stage in Black people which makes it difficult to treat leading to a poor prognosis and outlook.

Skin cancer comes with skin changes where the affected area has abnormal shape, color and size. In black skinned people, skin cancer can be usually found in areas like palms, lower legs and the soles of the feet.

Many of the skin cancers can be cured when diagnosed and treated in the early stages.

References:

Also Read:

• Squamous Cell Carcinoma of the Skin: Causes, Symptoms, Treatment, Prevention
• What is Skin Cancer: Signs, Symptoms, Detection & Diagnosis, Prevention, Risk Factor