Skin Cancer in Children

Do children get skin cancer?

Yes. Approximately two per cent of melanomas (the worst of the skin cancers) occur in patients under the age of 20 years, and about 0.4 per cent of melanomas occur in prepubertal children, says an article in the New England Journal of Medicine (NEJM).

For adults, the Canadian statistics show that for males, the incidence rate of melanoma has tripled since the late 1960s, from 3.2 per 100,000 population in 1969 to an estimated rate of 10.5 per 100,000 in 1998. For females the rate has varied a bit but still is on the rise.

It is known that high exposure to sunlight during childhood sets the scene for higher rates of melanomas as an adult. And history of sunburn as a child is a risk factor. Skin damage and probably skin cancer increases with one’s level of total cumulative exposure to the sun and number of sunburns, says an article in the Canadian Medical Association Journal (CMAJ).

People get more exposure to sunlight in July and August (just the way we are experiencing now) than at any other time of the year. Children are no exception. They spend more time outdoors than adults.

People with fair skin, such as those with Scandinavian ancestry, are more prone to sun damge than people with darker skin, says the CMAJ article. The death rate from melanoma also continues to rise about two percent annually.

What can we do to combat the rising incidence and death rate from melanoma?

According to Ca – a Cancer Journal for Clinicians, we need a three pronged approach to effectively deal with this problem:

1. Public awareness and understanding of melanoma must be improved.

We have to remember that melanoma is probably the most clear-cut case of a cancer where early detection and treatment are key to improving prognosis. New York University has developed ABCDs of early clinical signs of melanoma recognition. Public should be aware of these signs:

-Asymmetry
-Border irregular
-Color uneven
-Diameter greater than 6 mm.

2. Better methods are needed for identifying those at highest risk.

This can be achieved with more research. Hopefully, the future will bring more specific genetic and/or biologic risk models to make this exercise worthwhile.

3. More specific therapies for melanomas need to be developed.

Most early melanomas can be treated with wide surgical excision. But prognosis drops dramatically when the tumor has spread. There is no curative treatment available for advanced melanoma.

While we are waiting for scientific break through in many areas of melanoma, we can try and prevent melanoma by protecting against sun exposure and sun burn. Natural protection (shade) is considered the best protection. And sunscreen (SPF 15 or higher) should be adjunct to natural protection.

Wear sun protective clothing (tightly woven and dark in color). Wear wide brim hats. And use eyeglasses that block both UVA and UVB light.

Skin is a very precious and important organ of our body. It has many important functions. It is important for our survival. Let us protect it well – starting from childhood. There is no doubt that melanoma risk rises rapidly with increasing exposure to ultraviolet light in childhood. That’s where prevention should start and then continued into adult life.

Have a great summer!

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