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Does Where You Live Affect Your Melanoma Risk?

Does Where You Live Affect Your Melanoma Risk?

Melanoma causes more deaths than any other skin cancer—and your risk depends largely on your UV ray exposure.

Worried about skin cancer? If you’re debating whether to wear a hat or apply sunscreen before heading outside—go ahead and do it. A 2020 study in the International Journal of Cancer found that more than 9 in 10 U.S. cases of melanoma between 2011 and 2015 were attributable to exposure to ultraviolet (UV) rays, like those that come from the sun. What’s more, researchers discovered that some states had significantly higher rates of UV-linked melanoma than others—and they may not be the states you’d expect.

What is melanoma?
Melanoma is a type of skin cancer that forms in your melanocytes, cells located in the lower part of your epidermis. You can develop melanomas on any part of your body. In women, these growths appear most often on the legs—and in men, it’s the chest or back. They’re also commonly found on the face and neck. 

Though rates have risen steadily over the last few decades, melanoma makes up just 1 percent of new skin cancer cases annually. Approximately 100,350 melanomas will be diagnosed in the U.S. in 2020 according to the American Cancer Society (ACS).

That said, melanoma accounts for most deaths related to skin cancer. This is because when it’s not detected and treated, it spreads throughout the body more easily than other forms of the disease. The ACS estimates about 6,850 people will die of melanoma in 2020.

Some risk factors for melanoma can be controlled, including a primary risk factor: exposure to UV rays. Most of the UV rays we get come from the sun, though indoor tanning beds are also a chief source for many people. In fact, indoor tanning leads to more than 6,000 cases of melanoma annually, according to the Centers for Disease Control and Prevention (CDC). 

Some other risk factors for melanoma can’t be controlled, including age, gender, race and genetics:

  • Though it’s found among younger adults, your chances of developing melanoma rise as you grow older; 65 is the average age of diagnosis. 
  • The disease is far more common in white people than in non-white people. Whites are 20 times more likely than African Americans to develop melanoma.
  • Men are likelier to develop and/or die of melanoma overall, but women younger than 50 have higher rates of the disease. 
  • There is a genetic component; if your family has a history of the condition, your risk increases.

What the study says
Since melanoma risk depends largely on your exposure to UV rays, where you live may affect your chances of developing the disease. The International Journal of Cancer study found that UV-linked melanoma rates varied widely between states. When total state population was considered, Utah was number one with 36.3 cases per 100,000 residents, followed by Vermont and Delaware. These states rose to the top because they’re whiter overall in terms of population—and white people have a much higher risk of melanoma.

When just non-Hispanic white people were considered, UV-linked melanoma rates ranged from 15.1 cases per 100,000 people in Alaska to 65.1 cases for every 100,000 Hawaiians. Utah, Delaware, Georgia and California also landed in the top five, while Nevada, Washington DC, Indiana and Texas ended up with the lowest rates.

Location and elevation accounted for some of the differences. UV rays are stronger in areas closer to the equator. This would help explain why Hawaii—the state closest to the equator—had such a high incidence of UV-linked melanoma among white people. Higher elevations can also mean stronger UV rays, which may be why Utah ranked so highly. 

Other factors likely played into UV exposure, as well. These include time spent on outdoor activities, inadequate application of sun protection, use of tanning beds and practices for early detection. Minnesota had higher rates of UV-linked melanoma—even though it’s more northern and landlocked—possibly for these reasons.

To get their results, researchers compared U.S. melanoma rates between 2011 and 2015 to a baseline: Connecticut melanoma rates among white people from 1942 to 1954. During that time, people in the northeastern state would have spent comparatively less time outdoors and worn more conservative clothing, reducing their UV exposure.

How to lower your odds of melanoma
There is no foolproof way to prevent melanoma, but you can reduce your risk by taking a few smart precautions. First, make sure to safeguard yourself from UV rays. When you head outside, remember to always wear the best sunscreen for you, even if the weather is overcast. In one 2015 study of about 4,000 adults in the Journal of the American Academy of Dermatology, only about 14 percent of men and 30 percent women regularly used sunscreen on their faces and other exposed skin. 

In addition, wear sunglasses, protective clothing and a wide-brimmed hat. During the brightest hours of the day—usually around midday—stick to shady places or stay inside altogether. Avoid tanning beds at all costs.

Be on the lookout for changes in your skin, as well. Check yourself monthly for growths or moles, and report anything new or unusual to a healthcare provider. Regular dermatologist exams may be recommended for some people, especially if they are prone to moles.

Medically reviewed in February 2020.

Sources:
F Islami, A Goding Sauer, et al. “Cutaneous melanomas attributable to ultraviolet radiation exposure by state.” International Journal of Cancer. 2020.
National Cancer Institute. “Skin Cancer Screening (PDQ®)–Patient Version,” “Skin Cancer Prevention (PDQ®)–Patient Version,” “Skin Cancer (Including Melanoma)—Patient Version."
American Cancer Society. “What Is Melanoma Skin Cancer?” “Key Statistics for Melanoma Skin Cancer,” “Risk Factors for Melanoma Skin Cancer,” “Can Melanoma Skin Cancer Be Prevented?”
Centers for Disease Control and Prevention. “Preventing Melanoma.”
Skin Cancer Foundation. “Self-Exams Save Lives: Early Detection Starts With You.”
DM Holman, Z Berkowitz, et al. “Patterns of sunscreen use on the face and other exposed skin among US adults.” Journal of the American Academy of Dermatology. Vol. 73,1 (2015): 83-92.e1.

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