Purposeful work is taking place to improve disease recognition in all skin colours, including variations in skin cancer.
Awareness is needed when treating patients with darker skin for most conditions, not least skin cancer. A disease which is less common on brown, or black skin, yet tends to have a worse outcome.
This inconsistency has been well researched and bias, or cultural aspects are not the leading issue, neither are nominal genetic differences. A primary concern is knowledge within the medical profession.
General practitioners and dermatologists to a degree have long been trained in how conditions look on fair skin. This can delay correct diagnosis on ethic skin and remove the greatest gift any cancer sufferer can have, early treatment.
Initiatives are now thankfully being put in place to close the gap. They will assist over time, as would wider understanding.
Misconceptions In Society
The belief that those of us with dark skin do not get skin cancer is incorrect. Risk levels may vary according to skin colour but they are never at a level to be ignored, as recent research has confirmed.
A February 2021 study looked at worldwide historic records in some depth and concluded that UV exposure was a less important risk factor in darker skin. Not however a no risk factor, or that other causes can be set aside.
Studies in Africa have come to similar conclusions. The less melanin in one’s skin, the greater the risk of developing skin cancer but for all skin colours, protective measures from UV rays and lower exposure matter.
There are indications that darker skin could bring greater liability for the development and spread of skin cancers. Mutations along the tanning pathway and the behaviour of melanin related compounds, or other cells may be a factor.
The genetic differences across people of all colours really are small and further research is needed but is warranted. As our genetic understanding develops, so can treatment, although the key will always be vigilance.
Not Ignoring The Problem
Being less liable to a potentially fatal condition is a blessing but the thought that skin cancer is not a possibility for all of us needs to be set aside. This is as logical as stating that people with darker skin don’t go grey (also melanin related).
Self skin checks, or an annual check with an experienced dermatologist are worth the time they take. If you spot a new, unexplained problem on your skin, arrange for this to be seen by a consultant with appropriate knowledge, as soon as possible.
Skin cancers of all types, melanoma, squamous cell carcinoma, or basal cell carcinoma have unique clinical features in patients of African and Asian heritage. Being familiar with them makes a difference.