Skin Cancer

Skin Cancer is defined by the Skin Cancer Foundation as:

“Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors.”

According to the National Cancer Institute, there are 4 main types of skin cancer:

  • Basal cell carcinoma. It’s the most common type of skin cancer and it is formed in the lower part of the epidermis (the outer layer of the skin).
  • Squamous cell carcinoma. It’s the skin cancer that is formed in squamous cells, the flat cells that form the surface of the skin.
  • Neuroendocrine carcinoma of the skin or Merkel Cell carcinoma. Skin cancer that it is formed in the neuroendocrine cells. These are the cells responsible of release hormones in response to signals from the nervous system.
  • Melanoma. In this case, the skin cancer is formed in the melanocytes, which are the skin cells that make pigment. This type of cancer is the most aggressive. It can grow quickly and needs to be treated early.

Fontanillas, P., Alipanahi, B., Furlotte, N. A., Johnson, M., Wilson, C. H., 23andMe Research Team, … Auton, A. (2021). Disease risk scores for skin cancers. Nature Communications, 12(1), 160.

Han, J., Zhao, Y., Shirai, K., Molodtsov, A., Kolling, F. W., Fisher, J. L., … Angeles, C. V. (2021). Resident and circulating memory T cells persist for years in melanoma patients with durable responses to immunotherapy. Nature Cancer, 2(3), 300–311.

Yang, C., Tian, C., Hoffman, T. E., Jacobsen, N. K., & Spencer, S. L. (2021). Melanoma subpopulations that rapidly escape MAPK pathway inhibition incur DNA damage and rely on stress signalling. Nature Communications, 12(1), 1747.

Strickley, J. D., Messerschmidt, J. L., Awad, M. E., Li, T., Hasegawa, T., Ha, D. T., … Demehri, S. (2019). Immunity to commensal papillomaviruses protects against skin cancer. Nature, 575(7783), 519–522.

Rollison, D. E., Viarisio, D., Amorrortu, R. P., Gheit, T., & Tommasino, M. (2019). An emerging issue in oncogenic virology: The role of beta human Papillomavirus types in the development of cutaneous squamous cell carcinoma. Journal of Virology, 93(7).

Sun, Q., Lee, W., Mohri, Y., Takeo, M., Lim, C. H., Xu, X., … Ito, M. (2019). A novel mouse model demonstrates that oncogenic melanocyte stem cells engender melanoma resembling human disease. Nature Communications, 10(1), 5023.

Kurniawan, F., Kartasasmita, R. E., Yoshioka, N., Mutalib, A., & Tjahjono, D. H. (2018). Computational study of imidazolylporphyrin derivatives as a radiopharmaceutical ligand kit for melanoma. Current Computer-Aided Drug Design, 14(3), 191–199.

Lu, H., Liu, S., Zhang, G., Wu, B., Zhu, Y., Frederick, D. T., … Guo, W. (2017). PAK signalling drives acquired drug resistance to MAPK inhibitors in BRAF-mutant melanomas. Nature, 550(7674), 133–136.

Bundell, S. (2017). Digital doctor: AI singles out skin cancer from photos. Nature.

Premi, S., & Brash, D. E. (2016). Chemical excitation of electrons: A dark path to melanoma. DNA Repair, 44, 169–177.

Le Gal, K., Ibrahim, M. X., Wiel, C., Sayin, V. I., Akula, M. K., Karlsson, C., … Bergo, M. O. (2015). Antioxidants can increase melanoma metastasis in mice. Science Translational Medicine, 7(308), 308re8.

Premi, S., Wallisch, S., Mano, C. M., Weiner, A. B., Bacchiocchi, A., Wakamatsu, K., … Brash, D. E. (2015). Photochemistry. Chemiexcitation of melanin derivatives induces DNA photoproducts long after UV exposure. Science (New York, N.Y.), 347(6224), 842–847.

Niewold, T. B. (2011). Decoding melanoma. Science Translational Medicine, 3(83), 83ec74-83ec74.

Lucas, R., McMichael, T., Smith, W., Armstrong, B. K., Prüss-Üstün, A., & World Health Organization. (2006). Solar ultraviolet radiation: global burden of disease from solar ultraviolet radiation. World Health Organization.

Moodycliffe, A. M., Nghiem, D., Clydesdale, G., & Ullrich, S. E. (2000). Immune suppression and skin cancer development: regulation by NKT cells. Nature Immunology, 1(6), 521–525.

  • National Cancer Institute
  • The Wistar Institute
  • The Sidney Kimmel Comprehensive Cancer Center – Jhons Hopkins Medicine
  • DNA-Farber/Harvard Cancer Center
  • Melanoma Institute Australia
  • Mayo Clinic Research
  • Skin Cancer Foundation
  • Dermatology center, University of California San Francisco
  • Cancer Research UK Oxford Centre
  • Ludwing Institute for Cancer Research, University of Oxford.

In the case of melanoma, it has been showed that for age groups 44 and younger, females showed higher incidence rates, with a peak difference at 20-24 years. At ages older than 44, males exhibited higher incidence rates. This bimodal gender differences were not observed for non-melanoma skin cancer and this could be a consequence of the association of NMSC with cumulative exposure to solar UV radiation.1,2,3

There is some hypothesis that try to explain why melanoma is worse in men, but they have failed to reach a clear verdict on the causes of that difference. Some of those possible differences are caused by the less information that men have about the skin cancer and the fact that the makeup and other self-care products which contains sun protection are more often used by women.2 Other studies have related the differences between men and women with the expression of a particular gene, PPP2R3B. By the study of tissue samples from people with melanoma, the researchers found that greater expression of PPP2R3B correlated with longer survival times, and that the expression of the gene is higher in women.4

It’s a fact that the probability of developing an invasive cancer the type of melanoma of the skin, increases over the years in the case of the men, and their mortality is higher than the mortality of women. This could be explained if one considers that the diagnosis in men is given at older ages but it’s necessary more research in this field.5 Other things as the differences between the skin of men and women can be a relevant fact in the mortality and incidence of the melanoma, as the American Academy of Dermatology Association said.

REFERENCES

1Liu, F., Bessonova, L., Taylor, T. H., Ziogas, A., Meyskens, F. L., Jr, & Anton-Culver, H. (2013). A unique gender difference in early onset melanoma implies that in addition to ultraviolet light exposure other causative factors are important. Pigment Cell & Melanoma Research, 26(1), 128–135.

2Liu-Smith, F., Farhat, A. M., Arce, A., Ziogas, A., Taylor, T., Wang, Z., … Meyskens, F. L. (2017). Sex differences in the association of cutaneous melanoma incidence rates and geographic ultraviolet light exposure. Journal of the American Academy of Dermatology, 76(3), 499-505.e3.

3Liu-Smith, F., & Ziogas, A. (2020). Age-dependent interaction between sex and geographic ultraviolet index in melanoma risk. Journal of the American Academy of Dermatology, 82(5), 1102-1108.e3.

4Cancer genetics: Why melanoma is worse in men: Cancer genetics. (2016). Nature, 540(7634), 487.

5Khazaei Z., Ghorat F., Jarrahi A. M., Adineh H. A., Sohrabivafa M.,  Goodarzi E. Global incidence and mortality of skin cancer by histological subtype and its relationship with the human development index (HDI); an ecology study in 2018. WCRJ 2019; 6: e1265

  • The incidence for both sexes, is greater for the case of Europe (46%), follow by Northern America (30%), Asia (7.3%), Oceania (5.9%), etc.
  • The mortality for both sexes, follows a similar trend than the incidence, but in this case after Europe, one can found Asia with a 21% of mortality follow by Northern America (14.7%), Latin America and the Caribbean (9.9%), Africa (4.7%), etc.
  • The total number of new cases in 2020 was 324635, and the total number of deaths in the same year was 57043.
  • The mortality is greater in men than in women.
  • At older ages, increase the mortality.

*All of the above data is from Globocan 2020 of the International Agency for Research on Cancer-WHO.