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A recent Canadian study has found that rates of a deadly form of skin cancer are on the rise in Canada — and people living in certain parts of the country are at a higher risk of developing the disease.
Researchers analyzed data of cutaneous melanoma patients across Canada, except for Quebec, between 2011 and 2017. Of the 39,610 patients who were diagnosed with cutaneous melanoma, nearly 6,000 died.
The study, led by McGill University and published in the journal Frontiers in Medicine, says people living in southern and coastal areas are most at risk, with the maritime provinces of Prince Edward Island and Nova Scotia having the highest incidence rate of melanoma in the country.
Dr. Ivan Litvinov, senior author of the study, says people living in nice areas where the weather is pleasant want to get out more, highlighting the provinces of Nova Scotia, Prince Edward Island, coastal areas of New Brunswick, the entire corridor of southwestern Ontario and southern British Columbia.
“People need to be more vigilant when they're living in those communities,” Litvinov, who's an assistant professor and director of dermatology at McGill University, says. “We want everybody to go and enjoy the outdoors. Just do so without getting a tan, and definitely do so without getting burned, which will put the risk of melanoma at a very, very high level.”
In other parts of the county, the prairie provinces as well as Newfoundland and Labrador had lower rates of melanoma than the Canadian average, which is listed as 20.75 cases per 100,000 people per year.
What is cutaneous melanoma?
Cutaneous melanoma, also known as melanoma skin cancer, is a cancer that starts in the pigment-making cells of the skin.
There are four types of cutaneous melanoma, including superficial spreading melanoma which is the most common type of melanoma skin cancer.
The Canadian Skin Cancer Foundation says more than 80,000 cases of skin cancer are diagnosed in Canada each year, more than 5,000 of these are melanomas.
About 90 per cent of skin cancers are caused by UV rays, but the foundation says other factors can also determine your risk, including your complexion, the number of moles you have, and family history.
The Melanoma Network of Canada notes melanoma can affect anyone regardless of sex, age or race. The survival rate for melanoma skin cancer is high if it is detected early.
Who is most affected by melanoma skin cancer?
Researchers not only found that geography has a link to melanoma cases, but gender and age do as well. This is most likely driven by sun exposure practises, according to Litvinov.
Incidences of melanoma were found in 54 per cent of men versus 46 per cent in women, except for acral lentiginous melanoma, which often happen on fingers. Litvinov says this is possibly “due to higher exposure of ultraviolet radiation in nail salons.”
For women, melanoma is commonly found on the legs, followed by the arms and trunk. Whereas for men the skin cancer is usually found on the trunk, head and neck.
Rates of melanoma were also higher in people over the age of 60, Litvinov explains that’s because skin cancer risks increase with age due to “accumulated exposure to ultraviolet radiation from sunlight or other artificial sources."
This is not to say that skin cancer is not found in young people.
Melanoma is one of the most common types of cancer for youth between 15 to 29 years old. According to the Melanoma Network of Canada one blistering sunburn before the age of 20 can increase your risk of developing melanoma later in life.
Mortality rates of melanoma decreasing in Canada
Cutaneous melanoma causes more deaths than any other skin cancer, the study found, accounting for 1.9 per cent of all skin cancers in men and 1.2 per cent in women in Canada.
Globally there were 290,000 new cases of cutaneous melanoma in 2018, with Australia, New Zealand, Sweden, Netherlands, Denmark, Norway, and Germany seeing the greatest number of cases per capita.
While rates of the skin cancer are rising in Canada, researchers discovered that the number of people dying from the disease has been declining since 2013.
“That's in part due to the Canadian taxpayers who supported melanoma research to produce immunotherapies and targeted therapies that now promise about 50 per cent of patients with advanced melanoma prolonged survival, as opposed to before it was just a death sentence,” Litvinov explains during his interview with Yahoo Canada.
Why are melanoma cases on the rise in Canada?
Litvinov says there are several reasons why melanoma cases are increasing in Canada.
The first reason, he says, is that people are "addicted" to the sun — and expose themselves more than they would need physiologically for the vitamin D benefits.
“There are some people who really, when they stop going out in the sun or the tanning salon, they actually get like withdrawal symptoms,” the professor says. “The sun worshippers, they really need the sun, it's really an addictive behaviour."
A change in culture may also be contributing to the rise in melanoma cases, with people spending more time enjoying the outdoors and flying to warm and sunny destinations.
Litvinov also points out that people are living longer, which puts them at a higher risk of developing the skin cancer.
Another contributing factor behind the increase may be climate change and the thinning of the Earth’s ozone layer.
Recommendations for protecting your skin in the sun
Sun exposure doesn’t just cause skin cancer, it also causes wrinkles, dry skin and age spots.
Dr. Mary McKenzie, a dermatologist in Sunnybrook’s Melanoma Clinic, lists several ways of protecting your skin from the sun on the centre’s website.
Among her recommendations, McKenzie advises:
Using sunscreen with 30 SPF or higher if you’ll be outside
Protecting your lips with an SPF chapstick
Covering up with sun protective clothing or finding shade
Litvinov says young people need to learn about sun protection at an early age to prevent health risks later in life.
“We need a culture change in this country,” he says. “We've achieved this culture change with seatbelts and smoking, right? We sort of need to achieve the same thing in terms of sun exposure.”