9 ms·

Are we screening too much for skin cancer? It's complicated

34 points by laurex 5y ago

Vecr 5y ago
As far as I can tell, all cancer is being screened for too much, except possibly colorectal cancer, mostly just because there's other stuff that can be found in the same exam. If better treatments existed, it might become more worthwhile.
- asdff 5y ago
  Most cancers are a lot more treatable if caught early. Sometimes you can just cut it out and never relapse if caught early enough before it metastasizes. Screening is worthwhile.
bricemo 5y ago
This is a complicated space to get right. Prostate cancer is the opposite: The government used to screen for it (PSA blood test) and so people would see their doctor at stage 1 or 2 cancer, when it can be easily tested. But the problem was that the positivity rate was about 45:1, and the test is too expensive at that scale. So now PSA tests are not routine. As a result, people are now coming in to their doctors with prostate cancer at stage 3 or 4. Might be the right choice for society, but the wrong choice for the individual.
- google234123 5y ago
  It's definitely complicated because most of these older men with stage 1/2 prostate cancer will not actually die from it since it's so slow. However, getting the treatment for it leaves a huge number with erectile dysfunction or other issues. Is it really worth screening/treating a disease with a small chance to kill you if that treatment has a huge chance to make you impotent?
  - im3w1l 5y ago
    Depends on your values. Some people may think it's worth it for them, and that's valid.
    - cycomanic 5y ago
      I don't think it's as easy as "let the patient decide". First, probabilities are very abstract concepts for people, that's why people respond very differently to the dangers of things when given the probability. Some people are scared if there is a 1:1000 chance of something happening, others are reassured, but both might have very similar reactions if they actually get hit by the chance event. Secondly, also there is significant evidence of high incidence of depression for people with side effects, such as incontinence and impotence. I don't think people have the ability to assess that effect based on their values. To use an extreme example, should we operate something that has a 1:1000 change of killing you before something else, if it increases your suicide risk to 1:500? Should we allow patient to make that decision?
      - edmundsauto 5y ago
        Yes, patients should be making all decisions regarding their own health. Am I misreading you? Are you really suggesting they shouldn’t have these options because they might make a bad decision?
        google234123 5y ago
        This article is about screening which is a public health policy. Policies shouldn't promote things that are not effective. Anyway, patients can't make all decisions regarding their own health since most drugs need a medical prescription. And doctors won't just do any procedure that you ask them to.
      - jjk166 5y ago
        Yes, the unwashed masses can't handle abstract concepts like 1:1000 being smaller than 1:500. We certainly know better than them the value of years with the kids versus a physically satisfying romantic life, and if they think differently they are clearly just irrational plebs who should be hoodwinked for their own protection. We can't let a lifetime of unique experience and perspective stand in the way of a good one-size fits all system that produces better (for our definition of better) results on average.
- c152driver 5y ago
  Complicated indeed. For prostate cancer, the pendulum really seems to have swung in the direction of underdiagnosing. My dad was doctoring for several months with urinary tract systems. The doctor flat out told him "you don't have prostate cancer". It wasn't until he sought out a second opinion several months later that he was diagnosed with stage 4 prostate cancer.
- the-dude 5y ago
  I would like to share my personal view on prostate cancer screening : my father was found 'positive' at around ~61 yrs. He evaluated the offered treatments and opted for 'internal radiation' : a bunch of radio-active pellets are implanted in the prostate. I heard from him one of the pellets went 'missing' and was assumed to be 'wandering'. At 63 yrs, he developed acute leukemia and basically died within a week. I am not going to research and pursue this, but I am very bitter.
- DanBC 5y ago
  > As a result, people are now coming in to their doctors with prostate cancer at stage 3 or 4. Might be the right choice for society, but the wrong choice for the individual. Hypothetical Bob is going to die when he's 78. We can tell Bob he has prostate cancer when he's 76, or when he's 70. Telling him does not make him live longer. But telling him does mean he may undergo treatment that degrades his quality of life, or even shortens his life. How can we justify telling him when he's 70, when that won't make him live longer but could well make his life worse?
- LorenPechtel 5y ago
  The reason they quit screening for it is that prostate cancer screening was found to have zero benefit on the number that really matters: how many die. The thing is prostate cancer is usually a very slow cancer. Very often the proper response to a diagnosis of prostate cancer is keep an eye on it. Being aggressive about going after prostate cancer means more patients harmed by treatment (can you say "erectile dysfunction") but no lives saved. The few saved from cancer are offset by those who die from treatment. There are basically three types of cancers and note that other than by observing what happens over time the doctors can't tell them apart: Aggressive cancers. You're dead. The doctors putting you through hell might buy you a bit more time, but that's it. Slow cancers. In most patients you'll die with the cancer, not of it. Prostate cancer tends to fall into this category. Middle of the road cancers. These are the only ones where treatment is actually of much benefit to the patient. Found early enough you might even get a cure.
alexfromapex 5y ago
As someone who had an early melanoma detected and removed, I disagree with this. What I find frustrating is that they only attribute UV damage as the cause when it's probably a combination of UV damage and diet, or repetitive extreme UV damage combined with bad diet, etc.
- Clewza313 5y ago
  Serious question: what's the link between melanoma and diet?
  - nicwilson 5y ago
    presumably increased metabolic activity which equates to increased (epi)dermal turnover (among many other factors, e.g. immune surveillance). Increased turnover leads to more chance for errors during replication
MattGaiser 5y ago
I don't see how the answer is ever having less information. Seems that putting things on watch lists for possible future action would be more prudent.
dukeofdoom 5y ago
I once got stuck walking on a board walk behind an elderly man in a g-string european type swimwear in Hawaii. Looking at his extremely wrinkled ass, I quickly realized this man was addicted to sun bathing. Coming from a northern part of the world, did not know that was a thing. He looked about 70, formerly a white guy. So perhaps some people can develop some way of dealing with skin damage from the sun. The man needed to be studied by science. His immune system was trained to kill cancer cells daily.
- Clewza313 5y ago
  Well, it's also survivor bias. Melanoma rates are very high in Australia, which has lots of pasty people of European extraction toiling under some of the most brutal UV indexes on the planet.
  - ddeck 5y ago
    Indeed. Australia and New Zealand have the highest incidence rate for melanoma in the world. Ozone depletion plays a role, but interestingly, the Earth is also closer to the Sun during the southern hemisphere summer, resulting is ~7-10% greater solar UV intensity: Australia’s unusually harsh sunshine results mainly from its location in the Southern Hemisphere. The elliptical orbit of the Earth places the Southern Hemisphere closer to the sun during its summer months than the Northern Hemisphere during its summer. This means that the summer sun in Australia is 7 to 10 percent stronger than similar latitudes in the Northern Hemisphere. Air currents high in the atmosphere sometimes bring ozone-depleted air from Antarctica’s ozone hole to Australia, letting even more UV through. And Australia’s sunny weather and relatively pollution-free air provide little additional protection from harmful UV rays https://earthdata.nasa.gov/learn/sensing-our-planet/aerosols-over-australia https://earthdata.nasa.gov/learn/sensing-our-planet/aerosols...
- taneq 5y ago
  It depends a lot on the UV index. If you're near the hole in the ozone layer you get cancer before you get that tanned.
- StavrosK 5y ago
md224 5y ago
> “There’s no one trump card, no one criteria really that can tell us this is absolutely, without a doubt melanoma.” Does this bother anyone else? I really hope that level of uncertainty doesn't extend to too many other types of cancers...
- MattGaiser 5y ago
  > this is absolutely, without a doubt The standard in this phrase is also exceedingly high. Even a test with just a 1 in 1000 rate of false positives would not pass. But are you really going to doubt a test that only has a 0.1% chance of being wrong? I want a rate. Are half being misdiagnosed? 20%? 2%?
throwlotterywon 5y ago
Recently, I had a mole on the top of my foot about an inch or two from my toes that grew from a normal size small dot to bigger than a pencil eraser in the span of two months. I went to the doctor, not suspecting any cancer, but because it was ANNOYINGLY itchy and started to grow a red ring around it. For context, I'm a nerdy software engineer who RARELY ventures outside of an air conditioned room, obviously no tanning or anything like that. When I got there, the doctor, who was a local UCSF-trained expert, suddenly looked very stressed out and started taking pictures of it. He kept insisting I get tested for deadly skin cancer (remember, melanoma is AGGRESSIVE) in a very roundabout way, but would not give any probabilities or anything like that. The more I asked questions, the less information he would give about what was going on, other than that I should get a biopsy RIGHT NOW in his office (he even told his other patients to wait a while). He numbed my foot with a shot, and then took the dermatology equivalent of an ice cream scooper and dug out a sizable chunk of my flesh. I was told I had to wait for two weeks for the results -- the most agonizingly stressful two weeks of my life -- hearing the news was less stressful. "We'll call you if there's any problems, if you don't get a phone call, nothing is wrong. See you at your next appointment!" The results were a rare "spitz nevus" precancerous mole that looks exactly like melanoma but is completely benign. I had won the lottery. The doctor took even more pictures the next time. So, to answer the article's question, no we are NOT screening too much for skin cancer; otherwise, I would have known to be in the doctor's office a LOT sooner. And I am a shut-in who does not sun bathe or even go outside for more than 30 minutes at a time on the occasional weekend...
- rscho 5y ago
  Statistically speaking, your individual story says next to nothing about what we should do regarding screening. And screening strategies are all about statistical analysis.
  - throwlotterywon 5y ago
    What's the downside to screening more?
- taneq 5y ago
  I'm surprised he only took a sample. Where I live, anything suspected of being melanoma gets removed immediately, it's still sent off for testing to see whether it was cancerous or not but if you're taking a biopsy might as well just take it out entirely.
jedberg 5y ago
This sounds like the same arguments as whether mammograms should start at 40 or 50 years old. Apparently a lot of the cancers they catch during screenings at 40 would go away on their own, so now they only recommend mammograms before 50 if cancer runs in your family, to avoid unnecessary biopsies and other surgeries.
- aeternum 5y ago
  I've never understood this argument, more information should always be better. The real problem seems to be the knee-jerk biopsy/surgery. If a QA engineer points out a potential bug, it's foolish immediately/blindly delete chunk of code containing the bug. It's just as foolish to say we're randomly deleting too much good code, so let's fire the QA engineers.
  - arrosenberg 5y ago
    That’s a fine sentiment and all, but if you are looking for a logical response from most people in that situation, you’re gonna have a bad time.
  - dehrmann 5y ago
    > more information should always be better It's not, though. There's a cost to collecting the information, it's not always actionable, and it can be wrong. On the human side, there's a reason they say "ignorance is bliss."
  - jedberg 5y ago
    Think of it more like this: A QA engineer finds a bug. You spend a bunch of time diagnosing and fixing the bug. But it turns out that no user actually hit that bug because they never used that feature, and in fact that feature gets taken out in the next release. That's a lot of wasted time. Time better spent having the QA engineer only look at bugs reported by users and not looking for them on their own. In the case of the mammogram, it's even less clear cut. The mammogram only shows spots. A biopsy is necessary to determine if it's cancer. A biopsy is surgery and could have complications. And could in fact make the problem worse. So the idea is that you only do the test if you actually have symptoms or a family history of breast cancer, until the risk level gets high enough that it warrants going to look for cancer without symptoms.
jvidalv 5y ago
I think people overblowns it. I live in a rural town in Spain where most people are still farmers ( wineries, olives ). It means most of the men can take up to 6-7 hours, at minimum, of sun their entire life each day. Its a small town so we know whenever someone dies. In my 27 years never heard or someone died from skin cancer. There have been many lung cancers from smoking, prostata, belly... I dont know where this trend about skin cancer begun, maybe is a think for northen people and not mediterranean that we are more “brown”, and like everything it propagated like fire, trying to sell to you that if the sun hits you without protection youll get skin cancer. Sorry but no
- dagw 5y ago
  Studies I've seen from Sweden seems to suggest that the big problem is people going from no sun to lots of sun with no 'transition' period. Basically one big cause of the increase in skin cancer is people going straight from 4 month of basically no sun, to spending 2 weeks in Thailand sunbathing on the beach for hours a day. Another factor is altitude. The risk of skin cancer is higher the higher up you are. People who spend a lot time in the mountains are at higher risk compared to people closer to sea level (at the same latitude). Basically if you get a 'constant' amount of sun every day, are below ~1000-2000 m above sea level and stay reasonable covered up (wear a shirt, hat if you're bald etc.) the risks seem to be pretty low.
  - StavrosK 5y ago
    Hmm, I wonder if it's that us Mediterranean people have an easier transitional period and have learned to pace ourselves. I'll go out for a walk without sunscreen, but I'll definitely put it on if I go to the beach, when I'm going to be in the sea for an hour without a shirt on. Most people here are pretty tan unless they spend all day in an office.
    - saiya-jin 5y ago
      Which is fine for Mediterranean, but ie rest of europe looks exactly opposite - pale white from late autumn till late spring, very little to no sun exposure per day, sometimes nothing for a week or longer. And then super intense exposure over vacation or sunny weekends. I am not even talking about long hours in the office or covid lockdowns, just regular situation. When its colder then logically people dress more. Add more pale skin by default, meaning less genetic predisposition for good long term protection and the result is what we see.
narag 5y ago
My mother had a small one removed from her face a couple of weeks ago. It was detected very early thanks to a cosmetic procedure.
paul_f 5y ago
>Reviewers didn’t dispute the science, but they expressed concern that the findings might deter people from protecting themselves against the sun. This is truly bothersome. Science should only be a hunt for the truth.

34 points by laurex 5y ago

Vecr 5y ago

As far as I can tell, all cancer is being screened for too much, except possibly colorectal cancer, mostly just because there's other stuff that can be found in the same exam. If better treatments existed, it might become more worthwhile.

asdff 5y ago
Most cancers are a lot more treatable if caught early. Sometimes you can just cut it out and never relapse if caught early enough before it metastasizes. Screening is worthwhile.

bricemo 5y ago

This is a complicated space to get right. Prostate cancer is the opposite: The government used to screen for it (PSA blood test) and so people would see their doctor at stage 1 or 2 cancer, when it can be easily tested. But the problem was that the positivity rate was about 45:1, and the test is too expensive at that scale. So now PSA tests are not routine. As a result, people are now coming in to their doctors with prostate cancer at stage 3 or 4. Might be the right choice for society, but the wrong choice for the individual.

google234123 5y ago
It's definitely complicated because most of these older men with stage 1/2 prostate cancer will not actually die from it since it's so slow. However, getting the treatment for it leaves a huge number with erectile dysfunction or other issues. Is it really worth screening/treating a disease with a small chance to kill you if that treatment has a huge chance to make you impotent?
- im3w1l 5y ago
  Depends on your values. Some people may think it's worth it for them, and that's valid.
  - cycomanic 5y ago
    I don't think it's as easy as "let the patient decide". First, probabilities are very abstract concepts for people, that's why people respond very differently to the dangers of things when given the probability. Some people are scared if there is a 1:1000 chance of something happening, others are reassured, but both might have very similar reactions if they actually get hit by the chance event. Secondly, also there is significant evidence of high incidence of depression for people with side effects, such as incontinence and impotence. I don't think people have the ability to assess that effect based on their values. To use an extreme example, should we operate something that has a 1:1000 change of killing you before something else, if it increases your suicide risk to 1:500? Should we allow patient to make that decision?
    - edmundsauto 5y ago
      Yes, patients should be making all decisions regarding their own health. Am I misreading you? Are you really suggesting they shouldn’t have these options because they might make a bad decision?
      - google234123 5y ago
        This article is about screening which is a public health policy. Policies shouldn't promote things that are not effective. Anyway, patients can't make all decisions regarding their own health since most drugs need a medical prescription. And doctors won't just do any procedure that you ask them to.
    - jjk166 5y ago
      Yes, the unwashed masses can't handle abstract concepts like 1:1000 being smaller than 1:500. We certainly know better than them the value of years with the kids versus a physically satisfying romantic life, and if they think differently they are clearly just irrational plebs who should be hoodwinked for their own protection. We can't let a lifetime of unique experience and perspective stand in the way of a good one-size fits all system that produces better (for our definition of better) results on average.
c152driver 5y ago
Complicated indeed. For prostate cancer, the pendulum really seems to have swung in the direction of underdiagnosing. My dad was doctoring for several months with urinary tract systems. The doctor flat out told him "you don't have prostate cancer". It wasn't until he sought out a second opinion several months later that he was diagnosed with stage 4 prostate cancer.
the-dude 5y ago
I would like to share my personal view on prostate cancer screening : my father was found 'positive' at around ~61 yrs. He evaluated the offered treatments and opted for 'internal radiation' : a bunch of radio-active pellets are implanted in the prostate. I heard from him one of the pellets went 'missing' and was assumed to be 'wandering'. At 63 yrs, he developed acute leukemia and basically died within a week. I am not going to research and pursue this, but I am very bitter.
DanBC 5y ago
> As a result, people are now coming in to their doctors with prostate cancer at stage 3 or 4. Might be the right choice for society, but the wrong choice for the individual. Hypothetical Bob is going to die when he's 78. We can tell Bob he has prostate cancer when he's 76, or when he's 70. Telling him does not make him live longer. But telling him does mean he may undergo treatment that degrades his quality of life, or even shortens his life. How can we justify telling him when he's 70, when that won't make him live longer but could well make his life worse?
LorenPechtel 5y ago
The reason they quit screening for it is that prostate cancer screening was found to have zero benefit on the number that really matters: how many die. The thing is prostate cancer is usually a very slow cancer. Very often the proper response to a diagnosis of prostate cancer is keep an eye on it. Being aggressive about going after prostate cancer means more patients harmed by treatment (can you say "erectile dysfunction") but no lives saved. The few saved from cancer are offset by those who die from treatment. There are basically three types of cancers and note that other than by observing what happens over time the doctors can't tell them apart: Aggressive cancers. You're dead. The doctors putting you through hell might buy you a bit more time, but that's it. Slow cancers. In most patients you'll die with the cancer, not of it. Prostate cancer tends to fall into this category. Middle of the road cancers. These are the only ones where treatment is actually of much benefit to the patient. Found early enough you might even get a cure.

alexfromapex 5y ago

As someone who had an early melanoma detected and removed, I disagree with this. What I find frustrating is that they only attribute UV damage as the cause when it's probably a combination of UV damage and diet, or repetitive extreme UV damage combined with bad diet, etc.

Clewza313 5y ago
Serious question: what's the link between melanoma and diet?
- nicwilson 5y ago
  presumably increased metabolic activity which equates to increased (epi)dermal turnover (among many other factors, e.g. immune surveillance). Increased turnover leads to more chance for errors during replication

MattGaiser 5y ago

I don't see how the answer is ever having less information. Seems that putting things on watch lists for possible future action would be more prudent.

dukeofdoom 5y ago

I once got stuck walking on a board walk behind an elderly man in a g-string european type swimwear in Hawaii. Looking at his extremely wrinkled ass, I quickly realized this man was addicted to sun bathing. Coming from a northern part of the world, did not know that was a thing. He looked about 70, formerly a white guy. So perhaps some people can develop some way of dealing with skin damage from the sun. The man needed to be studied by science. His immune system was trained to kill cancer cells daily.

Clewza313 5y ago
Well, it's also survivor bias. Melanoma rates are very high in Australia, which has lots of pasty people of European extraction toiling under some of the most brutal UV indexes on the planet.
- ddeck 5y ago
  Indeed. Australia and New Zealand have the highest incidence rate for melanoma in the world. Ozone depletion plays a role, but interestingly, the Earth is also closer to the Sun during the southern hemisphere summer, resulting is ~7-10% greater solar UV intensity: Australia’s unusually harsh sunshine results mainly from its location in the Southern Hemisphere. The elliptical orbit of the Earth places the Southern Hemisphere closer to the sun during its summer months than the Northern Hemisphere during its summer. This means that the summer sun in Australia is 7 to 10 percent stronger than similar latitudes in the Northern Hemisphere. Air currents high in the atmosphere sometimes bring ozone-depleted air from Antarctica’s ozone hole to Australia, letting even more UV through. And Australia’s sunny weather and relatively pollution-free air provide little additional protection from harmful UV rays https://earthdata.nasa.gov/learn/sensing-our-planet/aerosols-over-australia https://earthdata.nasa.gov/learn/sensing-our-planet/aerosols...
taneq 5y ago
It depends a lot on the UV index. If you're near the hole in the ozone layer you get cancer before you get that tanned.
StavrosK 5y ago

md224 5y ago

> “There’s no one trump card, no one criteria really that can tell us this is absolutely, without a doubt melanoma.” Does this bother anyone else? I really hope that level of uncertainty doesn't extend to too many other types of cancers...

MattGaiser 5y ago
> this is absolutely, without a doubt The standard in this phrase is also exceedingly high. Even a test with just a 1 in 1000 rate of false positives would not pass. But are you really going to doubt a test that only has a 0.1% chance of being wrong? I want a rate. Are half being misdiagnosed? 20%? 2%?

throwlotterywon 5y ago

Recently, I had a mole on the top of my foot about an inch or two from my toes that grew from a normal size small dot to bigger than a pencil eraser in the span of two months. I went to the doctor, not suspecting any cancer, but because it was ANNOYINGLY itchy and started to grow a red ring around it. For context, I'm a nerdy software engineer who RARELY ventures outside of an air conditioned room, obviously no tanning or anything like that. When I got there, the doctor, who was a local UCSF-trained expert, suddenly looked very stressed out and started taking pictures of it. He kept insisting I get tested for deadly skin cancer (remember, melanoma is AGGRESSIVE) in a very roundabout way, but would not give any probabilities or anything like that. The more I asked questions, the less information he would give about what was going on, other than that I should get a biopsy RIGHT NOW in his office (he even told his other patients to wait a while). He numbed my foot with a shot, and then took the dermatology equivalent of an ice cream scooper and dug out a sizable chunk of my flesh. I was told I had to wait for two weeks for the results -- the most agonizingly stressful two weeks of my life -- hearing the news was less stressful. "We'll call you if there's any problems, if you don't get a phone call, nothing is wrong. See you at your next appointment!" The results were a rare "spitz nevus" precancerous mole that looks exactly like melanoma but is completely benign. I had won the lottery. The doctor took even more pictures the next time. So, to answer the article's question, no we are NOT screening too much for skin cancer; otherwise, I would have known to be in the doctor's office a LOT sooner. And I am a shut-in who does not sun bathe or even go outside for more than 30 minutes at a time on the occasional weekend...

rscho 5y ago
Statistically speaking, your individual story says next to nothing about what we should do regarding screening. And screening strategies are all about statistical analysis.
- throwlotterywon 5y ago
  What's the downside to screening more?
taneq 5y ago
I'm surprised he only took a sample. Where I live, anything suspected of being melanoma gets removed immediately, it's still sent off for testing to see whether it was cancerous or not but if you're taking a biopsy might as well just take it out entirely.

jedberg 5y ago

This sounds like the same arguments as whether mammograms should start at 40 or 50 years old. Apparently a lot of the cancers they catch during screenings at 40 would go away on their own, so now they only recommend mammograms before 50 if cancer runs in your family, to avoid unnecessary biopsies and other surgeries.

aeternum 5y ago
I've never understood this argument, more information should always be better. The real problem seems to be the knee-jerk biopsy/surgery. If a QA engineer points out a potential bug, it's foolish immediately/blindly delete chunk of code containing the bug. It's just as foolish to say we're randomly deleting too much good code, so let's fire the QA engineers.
- arrosenberg 5y ago
  That’s a fine sentiment and all, but if you are looking for a logical response from most people in that situation, you’re gonna have a bad time.
- dehrmann 5y ago
  > more information should always be better It's not, though. There's a cost to collecting the information, it's not always actionable, and it can be wrong. On the human side, there's a reason they say "ignorance is bliss."
- jedberg 5y ago
  Think of it more like this: A QA engineer finds a bug. You spend a bunch of time diagnosing and fixing the bug. But it turns out that no user actually hit that bug because they never used that feature, and in fact that feature gets taken out in the next release. That's a lot of wasted time. Time better spent having the QA engineer only look at bugs reported by users and not looking for them on their own. In the case of the mammogram, it's even less clear cut. The mammogram only shows spots. A biopsy is necessary to determine if it's cancer. A biopsy is surgery and could have complications. And could in fact make the problem worse. So the idea is that you only do the test if you actually have symptoms or a family history of breast cancer, until the risk level gets high enough that it warrants going to look for cancer without symptoms.

jvidalv 5y ago

I think people overblowns it. I live in a rural town in Spain where most people are still farmers ( wineries, olives ). It means most of the men can take up to 6-7 hours, at minimum, of sun their entire life each day. Its a small town so we know whenever someone dies. In my 27 years never heard or someone died from skin cancer. There have been many lung cancers from smoking, prostata, belly... I dont know where this trend about skin cancer begun, maybe is a think for northen people and not mediterranean that we are more “brown”, and like everything it propagated like fire, trying to sell to you that if the sun hits you without protection youll get skin cancer. Sorry but no

dagw 5y ago
Studies I've seen from Sweden seems to suggest that the big problem is people going from no sun to lots of sun with no 'transition' period. Basically one big cause of the increase in skin cancer is people going straight from 4 month of basically no sun, to spending 2 weeks in Thailand sunbathing on the beach for hours a day. Another factor is altitude. The risk of skin cancer is higher the higher up you are. People who spend a lot time in the mountains are at higher risk compared to people closer to sea level (at the same latitude). Basically if you get a 'constant' amount of sun every day, are below ~1000-2000 m above sea level and stay reasonable covered up (wear a shirt, hat if you're bald etc.) the risks seem to be pretty low.
- StavrosK 5y ago
  Hmm, I wonder if it's that us Mediterranean people have an easier transitional period and have learned to pace ourselves. I'll go out for a walk without sunscreen, but I'll definitely put it on if I go to the beach, when I'm going to be in the sea for an hour without a shirt on. Most people here are pretty tan unless they spend all day in an office.
  - saiya-jin 5y ago
    Which is fine for Mediterranean, but ie rest of europe looks exactly opposite - pale white from late autumn till late spring, very little to no sun exposure per day, sometimes nothing for a week or longer. And then super intense exposure over vacation or sunny weekends. I am not even talking about long hours in the office or covid lockdowns, just regular situation. When its colder then logically people dress more. Add more pale skin by default, meaning less genetic predisposition for good long term protection and the result is what we see.

narag 5y ago

My mother had a small one removed from her face a couple of weeks ago. It was detected very early thanks to a cosmetic procedure.

paul_f 5y ago

>Reviewers didn’t dispute the science, but they expressed concern that the findings might deter people from protecting themselves against the sun. This is truly bothersome. Science should only be a hunt for the truth.