Skin Cancer in People of Color: Understanding Disparities and Enhancing Awareness

Skin cancer affects individuals of all skin tones. Although darker complexion provides some protection against ultraviolet (UV) radiation, it does not eliminate the risk entirely. People of color, including those of African, Asian, Latino, Mediterranean, Middle Eastern, and Native American descent, are still at risk of developing this potentially serious condition. Further, skin cancer in these groups often goes undiagnosed until later stages, making treatment more challenging. This article explores the unique aspects of skin cancer in people of color, including clinical features, risks, and prevention strategies.

Understanding Skin Cancer Across Different Skin Tones

Skin cancer includes melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). UV radiation from the sun is a major factor contributing to skin cancer risk, affecting individuals regardless of skin color. While melanin in darker skin offers some natural protection, it is not sufficient to prevent all UV-related damage. Studies show that people with darker skin tones living in sunnier regions have higher rates of melanoma and other skin cancers.²

Clinical Features of Skin Cancer in People of Color

Melanoma in people of color is often diagnosed at a later stage, leading to poor outcomes. Research indicates that 75% of melanomas in Black patients occur on acral skin, such as the palms of the hands and soles of the feet, which are less exposed to sunlight and thus harder to detect.⁷ Non-acral melanomas in these patients are more commonly associated with immunosuppression or a history of other cancers. Melanomas in people of color frequently appear in less visible areas, such as the nails and mucous areas, complicating early detection. Delayed diagnosis often results in advanced disease at the time of detection.

Statistical Insights 

There are significant disparities in skin cancer outcomes among different racial and ethnic groups. Black patients with melanoma have a significantly lower five-year survival rate compared to their white counterparts. White patients with melanoma have a survival rate of around 94%, whereas Black patients have a rate of 70%.⁵  Additionally, 30% of melanoma cases in Black patients are diagnosed at advanced stages, compared to 13% in white patients.¹

The Role of UV Radiation and Skin Care 

UV exposure can lead to cellular DNA damage, resulting in skin aging, including wrinkles and spots, and can contribute to skin cancer in people of color. Studies have shown increased melanoma rates among Black and Hispanic individuals in regions with significant direct sunlight. Dr. Benjamin Tran, MD, a board-certified dermatologist in Los Angeles, California, and Georgetown University graduate, emphasizes that while melanin offers some SPF protection, all patients, regardless of skin tone, should wear sunblock. As a Medical Consultant for SkinCheck, he recommends an SPF level of at least 30 to provide effective protection for all skin types against harmful UV rays.

Effective Prevention and Early Detection 

Early detection is crucial for improving outcomes in skin cancer. Regular skin checks are essential, especially for people of color. Dermatologists recommend monthly self-examinations and lesion tracking to identify any new, changing, or unusual spots. Use a full-length mirror and a handheld mirror, or seek help from a partner to examine hard-to-see areas. Watch for signs such as dark spots or patches that grow, bleed, or change; sores that do not heal or recur; rough patches; and dark lines under or around nails. Less exposed areas, like palms, soles, and under nails, should also be examined closely.

Moving Forward

Addressing skin cancer disparities requires a multifaceted approach. Raising awareness through educational campaigns, such as the American Academy of Dermatology’s “SPOT Skin Cancer” initiative, and improving access to care are essential. Training healthcare providers to recognize skin cancer in all skin complexions and incorporating diverse case studies in dermatology training can significantly enhance outcomes.

SkinCheck is actively contributing to these efforts. Our app offers skin cancer detection features for a wide range of skin tones internationally, addressing disparities in both rural and urban areas. In the U.S., we currently enhance dermatology access with our lesions tracking feature and affordable telehealth appointments with board-certified dermatologists.

By increasing awareness and improving care access, we can achieve more equitable health outcomes and ensure effective skin cancer detection and treatment for all.