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Nonmelanoma: The Most Common Cancer

Nonmelanoma skin cancer (NMSC) is the most common form of cancer in the United States. There are an estimated 1.3 million cases each year in our country. There are more cases of NMSC than breast cancer, lung cancer, prostate cancer, and colon cancer combined, and nearly two-thirds of a billion dollars is spent annually to treat NMSC. 

What is NMSC, though? Nonmelanoma skin cancer can be broken up into two groups: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). 80% of NMSC cases are basal cell carcinoma, and the other 20% are squamous cell carcinoma. BCC is more prevalent, and it is less likely to become invasive and metastasize. There are about 2,300 deaths each year from NMSC, and the vast majority of those deaths are a result of SCC. 


Risk Factors

As the US population continues to age, and natural and artificial tanning become even more popular, it is important that the general public attains a greater understanding of NMSC and how it is treated, and it is even more important to know how it can be prevented. The primary risk factor for NMSC is sun exposure. Chronic sun exposure and sunburns, particularly blistering sunburns in childhood, are key factors in developing skin cancer. It is thought that approximately 80% of a person’s exposure to the sun takes place by the age of 18. Kids spend a lot more time outside than adults, but sun exposure can be harmful at any age.

Furthermore, exposure at different latitudes and elevations can be more harmful. For every 250 miles traveled closer to the equator, or for every increase of 2,500 feet in elevation, the intensity of sunlight and, resultantly, incidence of skin cancer doubles. At least 80% of NMSC occurs on the face, neck, and hands, but it can occur anywhere on the body. 

There are other risk factors for NMSC that go beyond exposure to sun the geographic location. As with many diseases, increasing age makes people more prone to NMSC. Men are more likely to develop NMSC, as are people with fair skin, light eyes, freckles, and those who burn more easily and tan poorly. People who smoke have a 50% risk increase in developing SCC, and those who have an outdoor occupation are twice as likely develop NMSC. 


Preventing Skin Cancer

When it comes to nonmelanoma skin cancer, prevention is of the utmost importance. Preventing NMSC is typically assumed to fall solely on sunscreen use, but studies have shown that sunscreen is normally applied at about one-third the recommended thickness.

Proper sunscreen usage employs a product with an SPF of 30. The higher the number, the longer it takes to burn. One ounce of sunscreen is the approximate dosage amount to cover the body, and it should be applied one half hour before exposure, as it takes between 20 and 30 minutes to be effective. If you are perspiring or spending time in water, reapplying sunscreen every 2 to 3 hours is necessary. 

Sunscreen in only part of a sun protection and NMSC prevention strategy. If outdoor activity of more than 30-45 minutes is planned, clothing offers much greater protection than sunscreen. A 3-inch brimmed hat and long sleeves are essential. As a general rule, the drier, darker, and tighter the fabric, the more protection the clothing offers. 

“An ounce of prevention is worth a pound of cure”

While treatment for NMSC is available and widely practiced, preventing NMSC is best. The words of Benjamin Franklin ring true: “An ounce of prevention is worth a pound of cure.” Practicing good sun protection is the best medicine when it comes to NMSC. Remembering to properly use sunscreen and wear sun-blocking garments is critical for preventing NMSC, and talking to your care provider about any suspicious dark spots or skin lesions is important. While nonmelanoma skin cancer is the most common form of cancer in the United States, safe sun protection practices can greatly reduce the likelihood of developing NMSC.