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The Honolulu Advertiser
Posted on: Monday, July 21, 2003

Hawai'i melanoma numbers cause concern

 •  Chart: Melanoma cancer by gender

By Robbie Dingeman
Advertiser Health Writer

The number of people diagnosed with melanoma, the deadliest of skin cancers, is steadily rising in Hawai'i and the nation, with the rate for men and boys here more than double what it was 25 years ago.

Brenda Hernandez, director of the Hawai'i Tumor Registry, said that about 330 new cases of melanoma are diagnosed each year in Hawai'i and that the disease has killed two dozen to four dozen Island residents a year for the past 10 years.

Melanoma has been the fastest-growing type of cancer among Hawai'i residents since 1975, Hernandez said, and it is the sixth most common cancer among men in the state (prostate cancer is No. 1).

However, Hawai'i's overall rate of melanoma remains slightly lower than the national average.

Healthcare officials point to various possible factors for the increase in melanoma.

Researcher Karen Glanz of the Cancer Research Center said it may be that melanoma, a slow-developing cancer, only now is showing up in sun worshippers who took part in the tanning craze of the '60s and '70s.

It could also be because of "people living longer and not dying of something else," Glanz said.

Protect your skin against sun

• Sunscreens with zinc oxide provide the most protection. Apply 20 to 30 minutes before going out in the sun to give it time to bind to skin cells. Reapply every two hours, or after swimming or perspiring.

• Try to stay out of the sun between 10 a.m. and 3 p.m.

• Wear protective clothing and hats. Specialized sun-protection clothing has ratings. Ordinary fabric can protect, too, if opaque when held up to the light.

• Protect your skin not just at the beach but during all outdoor activities such as yard work or watching sports.

Source: Hawai'i Skin Cancer Coalition

"The rise is mostly in white males," Hernandez said. "I think it's a combination of increased awareness with more cases diagnosed as well as an actual increase in the number of cases."

During the 1995-2000 period, new cases of melanoma were diagnosed in Hawai'i men at a rate of 20.5 for every 100,000 males, compared with a 8.4 rate from 1975-1979.

During that same time frame, the rate for women increased, going from 6.0 to 10.3.

Lifeguard Capt. Edmund Pestana, who works at Ala Moana Beach Park, said he has seen big changes in sun safety since he became a lifeguard in 1977.

Although some beachgoers still seek that perfect tan, he sees his colleagues slathering on sunscreen and taking care to cover up with hats and shirts.

"You can see us wearing rash guards all the time now," Pestana said. He said lifeguards monitor how well different sun-protection products work and compare notes.

"It's like a science for all of us now," he said.

He said new lifeguard towers offer more shade and that the city keeps lifeguards apprised of the latest information on identifying skin danger signs. Pestana said he even changed his medical plan so he could see a dermatologist regularly.

Hernandez, an assistant professor at the University of Hawai'i's Cancer Research Center of Hawai'i, said it's likely that men have a higher incidence of melanoma because they generally spend more time in the sun.

"UV exposure is the No. 1 risk factor. Men tend to do more physical activity outdoors, and it catches up as they get older," she said.

The overall rate for melanoma statewide remains lower than the national average.

From 1996 to 2000, the national average rate for melanoma was 17.5 for every 100,000 people, while the state average was 15.1 cases per 100,000.

Honolulu dermatologist Dr. Carla Nip-Sakamoto recommends that people look for sunscreens that contains zinc oxide or a transparent zinc oxide brand-name ingredient called Z-cote or Parsol. She said those ingredients offer what's known as broad-spectrum protection, effective against both ultraviolet A and B rays, while others may protect only against UVB.

Melanoma is caused by the more dangerous UVA. Although lotions that protect against UVB may prevent sunburn, it also may help lull people into a false sense of security because it allows them to stay outdoors without the warning pain of a burn.

Nip-Sakamoto usually advises most people to look for a sunscreen with SPF 30 or higher. SPF stands for sun protection factor. For example, skin protected by SPF 30 is supposed to take 30 times longer to burn than bare skin.

She said that no sunscreen provides 100 percent protection against the sun, but an SPF of 15 provides 93 percent protection, SPF 30 provides 97 percent protection, and SPF 50 provides 98 percent protection.

Experts caution people to protect children from sunburn, because even one severe sunburn early in life can increase the risk for developing skin cancer years later.

Nip-Sakamoto said that people of all skin types need to be careful about the sun.

"You can see skin cancer in Asian skin and Polynesian skin, not just Caucasian skin," she said. "People with dark skin who tan easily and rarely burn can still get cancer."

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.

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