Why is skin cancer on the rise among older adults?

Rising rates of skin cancer

The rise in skin cancer rates amongst over-55s is a worrying trend that has been seen in dermatology clinics across the country, says Dr Derrick Phillips, a skin specialist (dermatologist) and British Skin Foundation spokesperson.

Some of this has been caused by the rise of cheap package holidays abroad, as people over-55 were the first generation to go on these. “This meant holiday sun was accessible to the masses at a time when there was a lack of effective sunscreen, and a lack of understanding of the harmful effects of UV exposure,” says Phillips.

“As a result, many in this group accumulated significant sun damage in their early years. We now know that UV exposure in childhood and adolescence is an important risk factor for non-melanoma skin cancers, such as squamous cell carcinoma and basal cell carcinomas, which develop decades later.”

Additionally, population growth and greater awareness of skin cancer may also have contributed to the increase, as people may be more likely to get their skin checked.

Older adults less likely to use sun protection

Applying sun protection - such as lotions and creams containing SPF - and covering up using hats and appropriate clothing are important. However, research suggests that older generations may be less likely to use suncream, especially when in the UK.

In one survey, 45% of people said they rarely used sunscreen during the summer in the UK, even in sunny weather². A separate survey carried out in the US found that only around 15% of older adults regularly used sun protection³.

A misunderstanding of skin cancer risk may be the cause, as well as the belief that sun exposure later in life can lead to cancer. “However, melanoma - which can arise following short exposure to high intensity UV radiation - can develop over short time frames,” says Phillips.

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Cancer

Non-melanoma skin cancer

Non-melanoma skin cancers are any skin cancers that are not melanoma. The term is used because melanoma is very different to other skin cancers so it's important to think of them as separate types of skin cancers. Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are the main types of non-melanoma skin cancers.

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Types of skin cancer

The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma.

Basal cell carcinomas are slow growing skin growths that are shiny when illuminated and often have prominent blood vessels on their surface. They have rolled edges and a central dip with a tendency to scab and may appear as a non-healing wound. Most basal cell carcinomas occur on the head and neck.

Squamous cell carcinomas are quick-growing, scaly skin growths. They can be tender to touch and may also ooze or bleed. Again, they can appear as non-healing wounds but they are scaly and feel rough to touch.

Melanoma is another form of skin cancer that develops from the pigment-producing cells in the skin. It can arise from new or existing moles or sunspots. These can be seen as a change to an existing mole (think ABCDE as below) or as a brand new one that just comes up.

What are the signs of skin cancer to look out for?

It’s important to monitor your skin throughout the year and to look for new or changing moles or skin growths. When checking moles or pigmented marks on the skin, the ABCDE tool can help you to decide if your mole may be a melanoma and you need to be seen by a specialist.

ABCDE melanoma

For most people it is ok to check your moles every two to three months,” says Phillips. “However, for those at higher risk of skin cancer, more frequent checks are needed.

It's important to check your whole body for moles to monitor any changes to them - including under your nail beds and on your feet.

The main risk factors for skin cancer include having:

• Fair skin with freckles.

• A history of multiple sunburn episodes with blistering.

• More than 50 moles.

• Atypical or unusual moles.

• A personal or family history of skin cancer.

• Certain genetic conditions.

• Using medications that suppress the immune system.

How to prevent skin cancer

Skin cancer isn’t always preventable, but you can reduce your chance of developing it by avoiding overexposure to UV light from sunlight.

You can help protect yourself by:

• Using high-factor sunscreen such as a factor 50.

• Covering up in the sun - sleeves, hat and sunglasses.

• Never using sunbeds.

Further reading

1. Cancer Research UK: Soaring skin cancer cases hit a record high.

2. British Skin Foundation: BSF survey reveals nearly half of over 50s not using sunscreen during the summer in the UK.

3. Holman et al: Association between sun protection behaviours and sunburn among US older adults.