The increase in cases of skin cancer

Skin cancer cases have increased in recent years, in part because of excessive exposure to the sun. Carcinomas and melanomas in the form of nevus or moles are the two major types. Early diagnosis is essential for good treatment.

Prevalence of skin cancer in the population

Skin cancer has a high prevalence. It has been increasing progressively since the 60's of the last century and the forecast is that this trend will continue to increase in the coming years. To this contribute the change in the habits of life, among which the solar exposition stands out. Logically, the increase in life expectancy also implies a higher prevalence.

Types of skin cancer and diagnosis

There are different types of skin cancer that derive from the different cells that make up the skin tegument. In order of frequency, according to experts in Dermatology , there are basically two major groups:

• Carcinomas. They are the most frequent and, among them, the basal cell carcinoma and squamous cell carcinoma. Basal cell carcinoma is the most common not only of skin cancers but of all cancers in general. Its incidence is around 400 new cases per 100,000 inhabitants in our environment. Squamous cell carcinoma has a lower incidence, but is more aggressive.

Both tumors are preferentially located in chronically exposed areas to the sun, but may also occur in areas that are not exposed to the sun. There are precancerous lesions known as actinic keratoses that, in a variable percentage, can cause squamous cell carcinomas. Moreover, some authors consider these to be carcinomas in situ; ie localized only in the epidermis, and should be treated as a squamous cell carcinoma.

The incidence of actinic keratoses is very high, with a prevalence of 300 new patients per 100,000 inhabitants per year.

The clinical forms of these carcinomas are very varied: nodules, ulcers, plaques ... Sometimes flat lesions are not very noticeable and poorly delimited that are difficult to treat.

• Melanomas. This tumor originates from the melanocytes, which are the cells that produce melanin and cause our tan. In general, melanoma has a worse diagnosis than carcinomas, which is why early diagnosis is important.

The most frequent and worst prognosis melanoma is produced in areas of intermittent exposure to the sun; that is to say, the population that in summer exposes to the sun habitually covered areas, such as back or thorax. Melanoma may appear as a result of malignancy of a nevus or mole, but may also appear on previously healthy skin. 

Population at risk for skin cancer

The population at risk most frequently develops skin cancer is the population of fair skin, that burns easily and that broncea with difficulty, of blond hair or redhead. Likewise, the population that works outdoors is also at greater risk.

In the case of melanoma, the presence of nevus (moles) also influences, especially if they present atypical characteristics: asymmetry, different shades of color, etc.

Treatment of skin cancer and prevention

The treatment of skin cancer today is very varied, depending on the type of cancer and the stage in which it is. The usual is the complete surgical removal and anatomopathological study that gives us the safe diagnosis and if it is completely excised. However, there are situations in which surgery is complex or is a very aggressive method, or the esthetic result is not acceptable; in these cases other methods can be used as radiotherapy, photodynamic therapy, topical treatments or creams that can destroy superficial tumors, as well as cryotherapy with liquid nitrogen.

The early diagnosis of cutaneous cancer is a reality today and thus the volume of carcinomas that operate today has decreased in relation to past decades. In the case of melanoma, the systematic control of nevi and the removal of suspicious lesions has greatly improved the prognosis.

The tips, of course, are aimed at sunbathing with caution, avoid sunburn, especially in childhood, since the skin has memory. The correct use of photo protectors is recommended.. It is also important that the patient learn to self-check and monitor nevus periodically.