Although Oregon is known for its rainy season and cloudy skies, the state has one of the highest rates in the country for melanoma, the most serious form of skin cancer.
Oregon had 23 percent more cases in 2003 compared with the national average, according to the state Public Health Division. The department found 1,472 Oregonians were diagnosed with melanoma, and 789 of those were diagnosed with a deadly, invasive form.
Melanoma is a malignant tumor that originates in melanocytes, the cells that produce the pigment melanin, which colors the skin, hair and eyes. Melanoma can advance and spread to other parts of the body and becomes difficult to treat when it does, according to the Skin Cancer Foundation. The cancer can be fatal.
Melanoma causes the most deaths out of any other form of cancer. The American Cancer Society estimates there will be 8,110 deaths because of melanoma this year.
Area dermatologists aren’t sure exactly why melanoma rates are higher in the state, but they speculated Oregonians use tanning beds more and are exposed to the sun on vacations and during their childhood.
Theresa Devere, an assistant professor of dermatology at Oregon Health & Science University, said Oregonians often move to the state from California.
“They could have had a lot of childhood sun exposure,” Devere said, adding sun exposure at a young age increases the risk for melanoma later in life.
Oregon’s weather may indirectly play a part in the high rate of cases, Devere said. When Oregonians vacation in sunny spots like Hawaii, they are often exposed to the sun for long periods of time.
“We know that five or more sunburns in a lifetime increases risk,” Devere said.
Oregonians also turn to tanning beds more often to get a tan, Devere said. She added tanning beds increase the risk of melanoma because of their intense exposures.
Earlier this year, the International Agency for Research on Cancer concluded that use of tanning beds before age 35 increases the risk of developing melanoma.
Devere speculated those working outside in the sun in eastern and southern Oregon also play a role in the high rate of melanoma.
Misdiagnosis – diagnosing patients with melanoma even though they may not have the cancer – doesn’t play a part in the numbers, Devere said.
“We’re diagnosing so much earlier,” she said. “More cases are being diagnosed, which isn’t different than in any other state.”
Troy Richey, a dermatologist with offices in Eugene and Springfield, said he wasn’t sure why the rate of melanoma is higher in Oregon.
He said the rate could be higher because Oregonians enjoy outdoor activities and spend their time outside during sunny weather.
Richey said there is a higher incidence of melanoma in white-collar workers compared to blue-collar workers.
“It makes you wonder if melanoma is more common with intermittent sun exposure, rather than continual exposure,” he said.
The University of California’s San Francisco School of Medicine found in a 2006 study that patients who suspect they have melanoma may have trouble finding help.
Researchers called 851 dermatologists across the U.S. and found the average waiting time for those who thought they had a changing mole was 38 days.
Devere said Oregon is short on dermatologists, but the rest of the nation is also experiencing the same shortage.
Since the 1990s, the number of dermatologist residents trained in the U.S. each year has remained steady at about 300, but the population has grown about 15 percent, according to the Dermatology Online Journal.
Patients are also demanding more cosmetic procedures, including Botox. The American Academy of Dermatology found that 53 percent of dermatologists spend about one-fifth of their office hours performing cosmetic procedures.
Richey said increased focus on cosmetic procedures doesn’t mean dermatologists aren’t spending time treating serious cases.
“Doctors are paying attention to patients’ skin,” he said. “That’s why more people are getting diagnosed. You have to pay attention to get diagnosed.”
Devere said a possible solution to lowering the melanoma rates in Oregon include reducing tanning bed use and calling for more regulation at tanning bed salons.
“We’re seeing more young people with melanoma,” she said.
Gretchen Rosenberger, spokeswoman for the American Cancer Society, said about 90 percent of melanomas are curable when found at an early stage.
Prevention is key, she said.
“We recommend self-examination once a month and an examination by a health care professional as part of a cancer-related annual check-up,” Rosenberger said. She recommended avoiding the sun between 10 a.m. and 4 p.m. and wearing sunscreen with an SPF of 15 or higher.
Devere said melanoma strikes from pre-existing moles half of the time. She said to check moles for change in color and an increase in diameter.
The dermatology professor also said students may be getting new moles, but it’s unusual for new moles to appear beyond their 20s.
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