Why Skin Cancer is Often Missed in People of Color

Black people are more than three times as likely to be diagnosed with melanoma at a late stage than white people, while Hispanic people are more than 1.5 times as likely, according to one study. This is a deadly problem because the more advanced a cancer is, the more difficult it is to treat. To put it in perspective, one study found that the average survival rate for Black patients diagnosed with melanoma between 2001 and 2014 was around 24% lower than that in white patients. 

Why is there such a large discrepancy?

The main cause is a lack of awareness, research, and clinical trials about how skin cancer affects people of color, says ​​Dr. Joyce Imahiyerobo-Ip, CEO of Vibrant Dermatology in Greater Boston, MA. This “leads to a lower index of suspicion of skin cancer, delays in diagnosis, and ultimately, poorer prognoses,” she says. 

One study found that medical students were more accurate in diagnosing a common type of skin cancer in white people than in people of color. Plus, “many dermatologists-in-training practice in predominantly white areas making it less likely that they will see skin cancer in darker skin types,” says Dr. Imahiyerobo-Ip. 

Myths about skin cancer are also widespread. One long-held false belief is that melanin reliably protects deeper skin tones against skin cancer. While it does block some UV light, melanin only offers a nominal amount of natural protection – SPF of about 4 to 13 – which isn’t enough to prevent skin cancer, according to Dr. Imahiyerobo-Ip. 

What does skin cancer look like on melanated skin? 

Lesions can be camouflaged on darker skin, making them harder to spot. It’s important to pay attention to changes in the skin's texture and examine areas of the body that get little to no sun exposure, including the palms, soles of the feet, and under the nails. People of color are more likely to get skin cancer in areas of the body that are not exposed to the sun due to a specific type of melanoma.

Your move

 To make sure you have healthy skin, follow these tips recommended by Dr. Imahiyerobo-Ip:

• Perform skin self-exams about once a month, according to the AAD. 

• Bring suspicious growths directly to a dermatologist. Going to your primary care doctor won’t suffice because they may not be educated on “the nuances of skin cancer, particularly in skin of color,” says Dr. Imahiyerobo-Ip. 

• Find a provider who makes you feel heard. Dr. Imahiyerobo-Ip says good doctor/patient relationships are essential to preventing delayed diagnoses. 

• Wear sunscreen with an SPF of 30 or higher and reapply every two hours. We’ve said it before, and we'll say it again. 

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Well, Actually

We’re here to fact-check health trends, wellness assumptions, and myths. Such as:

Do you need to lower your cortisol levels? 

Well, actually, it’s complicated.  

A quick refresh: Cortisol is a hormone released by your adrenal gland as part of the body’s fight-or-flight response. That’s when your heart rate and blood pressure temporarily increase while you’re on high alert during a stressful situation. They should go back down after the perceived threat goes away, says Dr. Eva Beaulieu, a practicing internist based in Atlanta and author of “Paging Doctor You.” The issue? When stress becomes chronic, cortisol levels can also remain elevated. 

High cortisol levels aren’t something you can necessarily feel or self-diagnose, says Dr. Beaulieu. That said, if you’re noticing increased anxiousness, sleep issues, or headaches — all signs of chronic stress — it might be time to find solutions to help you better manage your stress. Dr. Beaulieu suggests meditating, journaling, or talking to a therapist. "It's best to deal with the underlying issue," she says. Your doc can test your levels, help you understand the results, and come up with a plan if needed. Read more about managing your cortisol levels here.