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Risk Factors

We must first understand the risk factors contributing to skin cancer to work toward protection and prevention.

  • Risk Factors for all skin cancers: [1]

    • UV radiation from sunlight or indoor tanning 

    • Having fair, or lighter-colored skin

    • Weakened immune system

    • History of skin cancer

  • Melanoma-specific risk factors include: [1]

    • Family history (Defined as a 1st-degree relative. i.e., mom/dad, children, sibling)

    • Advanced age

    • Presence of large, atypical (“ugly duckling”), or numerous (50+) moles. 

      • Yes – “ugly duckling” is a word dermatologist use

 UV Radiation

  • It is estimated that greater than 90 percent of nonmelanomas and a vast majority of melanomas are caused by UV exposure. [2,5] 

  • UV radiation is emitted from the sun. Human eyes cannot see ultraviolet light because the wavelengths are shorter than visible light. Two types of UV include:

    • UVA - longer wavelength, penetrates deeper into our skin, and is strongly associated with premature skin aging.

    • UVB - shorter wavelength, affects mostly our outer layers of skin and is strongly associated with sunburns

  • UVA & UVB contain enough energy to damage our skin’s DNA and create genetic mutations.

  • With every tan or burn, you are damaging the DNA in your skin. The more often you damage your DNA, the risk of getting skin cancer increases. 


 Let’s put it into perspective... How harmful is UV radiation, and what is the association with skin cancer?

  • The World Health Organization’s International Agency for Research on Cancer has classified UV-emitting tanning devices as a Class 1 Carcinogen, meaning it is a known carcinogen.

    • Placing it in the same category as cigarettes and asbestos. [6]

  • Individuals younger than 30 are six times more likely to develop melanoma if they tan indoors. [7]

  • Having five or more sunburns doubles your risk for melanoma [3]

  • Even just one blistering sunburn more than doubles an individual's risk of developing melanoma. [4]

 Fair – or light colored – skin

 Let’s compare two separate people:

  • Person A has extremely fair skin, always burns, and never tans.

    • We call this Fitzpatrick Type 1 skin 

  • Person B has nearly black skin, never burns, and tans very easily.

    • We call this Fitzpatrick Type 6 skin 

  • Person A has nearly a 30-fold increased chance of developing skin cancer when compared to Person B. [1]


Melanoma-Specific Risk Factors

 There are two major risk factors for melanoma. One we are born with, and the other is  modifiable (meaning you own the ability to change your risk!)

 1.  Genetics

  • Skin type

    • People with lighter skin types who burn easily are at a much higher risk than Black/Brown/Asian skin tones.

      • Roughly 30-fold higher risk, according to a recent study. [1]

  • Number of moles

    • Most melanomas arise out of the blue. However, 25% of melanomas arise from preexisting moles. [8] So the more moles an individual has, the greater risk. 

      • Think of this as a spectrum. 

  • Family history of melanoma

    • This is the strongest risk factor, stressing the importance of annual skin exams for those with a family history. [8]

    • Having a personal history of melanoma also means you are at nearly an 8-fold increased risk for developing another melanoma. [9]

 2.  Environmental

  • UV exposure

    • You guessed it! Both natural and artificial UV exposure greatly increases your risk of melanoma. 

    • Cigarettes are to lung cancer as tanning is to melanoma. 

      • Those who artificially tan have a 75% increased risk of melanoma. [10]

Updated: 10/7/2022

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  1. American Cancer Society. Cancer Facts & Figures 2022. Atlanta: American Cancer Society; 2022.

  2. Koh HK, Geller AC, Miller DR, et al. Prevention and early detection strategies for melanoma and skin cancer: Current status. Arch Dermatol 1996; 132(4):436-442.

  3. Pfahlberg A, Kölmel KF, Gefeller O. Timing of excessive ultraviolet radiation and melanoma: epidemiology does not support the existence of a critical period of high susceptibility to solar ultraviolet radiation-induced melanoma. Br J Dermatol 2001; 144:3:471-475.

  4. Lew RA, Sober AJ, Cook N, et al. Sun exposure habits in patients with cutaneous melanoma: a case study. J Dermatol Surg Onc 1983; 12:981-6.

  5. Parkin DM, Mesher D, Sasieni P. Cancers attributable to solar (ultraviolet) radiation exposure in the UK in 2010. Br J Cancer 2011; 105:S66-S69

  6. List of Classifications, Agents classified by the IARC Monographs, Volumes 1–124". IARC Monographs on the Evaluation of Risk to Humans. IARC. July 7, 2019. Retrieved Oct 1, 2022.

  7. Lazovich D, Isaksson Vogel R, Weinstock MA, Nelson HH, Ahmed RL, Berwick M. Association Between Indoor Tanning and Melanoma in Younger Men and Women. JAMA Dermatol. 2016;152(3):268-275.

  8. Carr S, Smith C, Wernberg J. Epidemiology and Risk Factors of Melanoma. Surg Clin North Am. 2020 Feb;100(1):1-12. doi: 10.1016/j.suc.2019.09.005. Epub 2019 Nov 4.

  9. Beroukhim K, Pourang A, Eisen DB. Risk of second primary cutaneous and noncutaneous melanoma after cutaneous melanoma diagnosis: A population-based study. J Am Acad Dermatol. 2020;82(3):683-689

  10. International Agency for Research on Cancer Working Group on artificial ultraviolet (UV) light and skin cancer. The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. Int J Cancer. 2007 Mar 1;120(5):1116-22. 

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