Thanks to their darker skin pigmentation, African Americans are less likely than members of other racial and ethnic groups in the United States to develop skin cancer. However, this does not mean that African Americans should ignore the possibility of skin cancer completely. Although the rates of occurrence of various types of skin cancer are lower in African Americans, they are not zero. African Americans can develop skin cancer, and when they do, the outcome is often more serious than it is for other Americans.
One reason why the outcome of skin cancer is often poorer in African Americans is that the disease is often diagnosed at a more advanced stage, when treatment is more difficult. Also, the type of melanoma most frequently found in African Americans is acral lentiginous melanoma, which is more dangerous than the types of melanoma that predominate in white Americans.
Statistics from various parts of the United States indicate that survival rates for African American patients diagnosed with melanoma are lower than those of white patients. For example, the California cancer registry reported a five-year survival rate of 70% for African American melanoma patients, as compared to 87% for white patients. Similarly, at the Washington Hospital Center in Washington, DC, the five-year survival rate for African American patients was 59%, compared to 85% in whites. The lower survival rate in African Americans was due largely to the fact that they tended to have more advanced disease - particularly disease that had spread to other parts of their bodies - when they were diagnosed with melanoma. When melanoma has spread to other parts of the body, it is highly lethal.
Among African Americans, melanomas occur mainly on body sites that are not pigmented, such as the palms of the hands, the soles of the feet, and the skin beneath the nails. Other sites at which melanomas occur relatively often in African Americans are the mucous membranes of the mouth, nasal passages, and genitals.
Like people of other heritages, African Americans should develop an awareness of the moles on their bodies and be alert for new or changing moles. In addition, African Americans should examine their fingernails and toenails for suspicious changes, which may include brown or black colored stripes under the nail or a spot that extends beyond the edge of the nail. Anyone who notices such changes should see a doctor promptly because they may be signs of melanoma. Melanoma that is detected and treated early can usually be cured.