Evergreen State is prime turf for skin cancer

August 16, 2011

By Tom Corrigan

With cloud cover not only being common, but seemingly the norm around Puget Sound, many locals may not be overly worried about exposure to the sun and the possibility of skin cancer such exposure can cause.

Living in one of the highest zones in the United States for rates of skin cancer, residents should keep an eye out for the development of asymmetrical moles. Thinkstock

That might be a big mistake according to area doctors and the national Centers for Disease Control and Prevention.

According to the CDC, the rate of new melanoma diagnoses in the state are 35 percent higher than the national average from 2001-2005. Melanoma is the most dangerous type of skin cancer.

The occurrences of melanoma in the state was the fifth highest in the country. An estimated 1,900 state residents were diagnosed with melanoma in 2008. The two most common forms of skin cancer — basal cell and squamous cell carcinomas — are highly curable, according to Roger Muller, senior medical director for United Healthcare of Washington.

Melanomas are not. Approximately 175 people in Washington die of melanoma each year, according to the CDC. That’s the 16th highest melanoma death rate nationally and 7.4 percent higher than the national average. In a seemingly odd statistic given our local climate, Washington’s Island County is among the top 10 counties in the country for new melanoma cases striking the area at the dangerous clip of 130 percent above the national average.

“At first blush, I can see how the numbers could be surprising given that much of the year here is cloudy,” said Arlo Miller, a dermatologist with Virginia Mason Issaquah. “However, digging into melanoma risk factors … it actually makes a lot of sense.”

Like other states with high melanoma rates, Miller said Washington has a dense population of persons of white, European descent. Melanoma strikes hardest at those with certain biological traits: red or blonde hair, light-colored eyes, a tendency to freckle or a susceptibility to burning. All of those risk factors are represented in a typical Caucasian population.

“Essentially, the state has an at-risk population,” Miller said.

Further, dangerous sun exposures come in two varieties, he added. One is chronic, say that experienced by a cattle rancher. The second is intense, sudden exposure, say what you might get on a vacation to the Bahamas. Or on a sudden, sunny day in the Puget Sound area. Intense, sudden exposure can cause dramatic increases in the rate of dangerous melanomas.

“Around here,” Miller said, “sun exposure comes in fits and spurts during a few amazingly bright and sunny summer months, so things will be skewed towards melanoma.”

Miller added that the main culprit for skin cancer isn’t direct sunlight, but ultraviolet light. And cloud cover is a poor ultraviolet filter, he said, meaning residents can get lulled into a false sense of security regarding sun exposure. With cloud cover comes lower temperatures, Miller added, and most people wear heavier clothing and end up protecting their arms and legs from exposure.

“However, their face is still exposed,” he said. “So while it seems nutty, this is why I encourage people to find a way to incorporate a facial sunscreen into their daily regimen.”

Miller also dismisses what he called a widespread Northwestern theory that says all the cloud cover impedes the creation of vitamin D that occurs when skin is exposed to natural sunlight. Some people end up believing there are medical benefits to tanning.

“You can get enough sun in Seattle to cause skin cancer, but not enough to boost your Vitamin D levels,” Miller said.

Not incidentally, tanning beds are not at all a safe alternative to tanning outside. Tanning beds are actually likely to be worse on your skin than natural sunlight since the beds are designed to deliver high doses of radiation in a short amount of time. The World Health Organization places use of tanning beds into their highest category of cancer causing behaviors since, according to Miller, the beds clearly are linked to skin cancer. Miller even compares tanning beds to cigarettes.

The CDC offers numerous steps people can take to protect themselves from the sun. Some are common sense, such as the use of sunscreen. They also recommend avoiding tanning beds. Finally, the CDC says stay in the shade and wear long pants and long sleeves. Miller admits the latter might seem like overkill.

At the same time, he said he’s never met a farmer who wore short pants and most of the older generation wears long sleeves and a hat.

“They had this figured out,” Miller said. “If you spend a large amount of time in the sun as a gardener, a biker or work outside, the same habit of covering up would make sense.”

Miller also talked about the social pressure to tan, especially among younger people. But he argued sun exposure causes skin to age.

“If it weren’t for sun exposure, our skin would be as soft and blemish free as a newborn’s,” Miller said. “Intentional tanning is like pressing eight times fast-forward on the aging clock.”

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