Macho factor and skin cancer
Here’s some advice more guys should follow: Keep your shirt on. While you’re at it, find yourself a hat with a wide brim and learn to love sunscreen too. Skin cancer rates are rising in the United States, and men are far more likely than women to develop the disease and to die from it.
According to the American Cancer Society, the number of non-melanoma skin cancers detected in the U.S. is increasing by about 5% a year. (The two most common forms of non-melanoma skin cancer are basal cell carcinoma and squamous cell carcinoma.) Men are twice as likely as women to develop non-melanoma skin cancer. While rarely fatal, these cancers can spread to other organs if neglected (especially squamous cell carcinomas) and account for about 2,200 deaths (of men and women) in the United States each year.
Why is skin cancer more common in males? “Men may simply be getting more of the kind of ultraviolet exposure that’s relevant,” says dermatologist Allan C. Halpern of Memorial Sloan-Kettering Cancer Center in New York.
The incidence of melanoma, the deadliest form of skin cancer, has been increasing at a rate of slightly less than 3% per year. A study last year found that the death rate from melanoma has increased 50% in the United States since 1969. Men age 65 and older accounted for most of the increase; deaths from melanoma in those men rose 157%, three times faster than in women age 65 and older.
Scientists have linked melanoma to skin damage caused by severe sunburns that occur at a young age. So it could be that high rates among men today reflect recreational habits of the past, when boys were more likely to play outside under the scorching sun, while their sisters spent more time indoors. Non-melanoma cancers appear to be caused by chronic exposure to the sun’s ultraviolet rays, for example, among people who spend a lot of time working outside. Again, men are more likely than women to work at outdoor jobs, such as farming and construction.
Halpern says that one reason more men die of skin cancer could be that the disease is more aggressive in males. However, there’s strong evidence that men do a poor job of monitoring and protecting their skin. For instance, doctors know that skin cancer, which is easily treated if detected early, is often discovered at a later, more dangerous, stage in men. Halpern and several colleagues published a study in January showing that women were nearly twice as likely to attend free skin cancer screenings sponsored during a 15-year period by the American Academy of Dermatology.
There is some evidence to suggest that men are much less likely to use sunscreen, and to use it properly, than women.
Part of the male aversion to sunscreen -- and skin care in general -- may be cultural. Young women are encouraged early on to use various skin lotions and moisturizers as a way to enhance physical beauty. Most maturing boys, meanwhile, don’t get beyond Clearasil. As a result, “men never get in the habit of applying things to their skin,” says Boston University dermatologist Barbara Gilchrest, a coauthor of the study. “Women are much more compliant in taking care of their skin.”
That’s not surprising, say Gilchrest and other experts, because studies show that men are less diligent than women in tending to health matters. But it seems as though even men who get their cholesterol measured and prostates examined annually may be inclined to neglect their hides. Fussing over your skin just doesn’t seem manly in some circles. The typical guy, says Brown University dermatologist Martin Weinstock, “may hear on TV that he should look at his skin and say, ‘Oh, that’s for women.’ ”
Attitudes may be changing, though. Trend-spotters say younger American males are gradually adopting personal-care habits once considered feminine, including paying attention to the appearance of their skin. If a guy can learn to apply skin toner and moisturizer, maybe he’ll be more inclined to use sunscreen and perform a monthly skin-cancer exam. (Weinstock, chairman of the American Cancer Society’s skin cancer advisory group, suggests starting with the head and working down to the toes. Have a spouse or partner look at your back for unusual spots because one-third of melanomas arise there.)
There are signs, too, that people are heeding the warnings about skin cancer. Over the last 30 years, melanoma death rates have actually dropped among American males between ages 20 and 44. Young men may be getting the message, says Alan Geller, a research associate professor of dermatology at Boston University. But the message needs to be louder, he says, because studies show that sunscreen use is very low among teenage boys in particular.
So if you still think a deep, dark tan makes you look more macho, talk to someone who has battled melanoma. “Patients who get skin cancer,” says Gilchrest, “quickly change their aesthetic.”
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Skin cancer’s toll
Skin cancer rates are increasing in the United States, and men are far more likely than women to develop the disease and to die from it. Below are estimates of newly diagnosed cases of skin cancers and deaths for 2002.
New Cases
Male... 30,100
Female... 23,500
Total... 53,600
Deaths
Male... 4,700
Female... 2,700
Total... 7,400
Source: American Cancer Society
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Timothy Gower can be reached by e-mail at tgower@comcast.net. The Healthy Man runs the second Monday of the month.
