Study reveals alarming rise of skin cancer in India, calls for action

One of the most diagnosed cancers is skin cancer, according to experts. It is predominantly seen in adulthood, and one of the main causes for its occurrence, as per research, is “accumulated ultraviolet radiation exposure throughout one’s lifetime.” 

A recent report published in The Lancet online suggests that prevention of skin cancer can be initiated in childhood itself. “It is the childhood period that plays a pivotal role in the deceptively invisible process of sun exposure. Sun exposure during the early stages of life has a more significant impact on the likelihood of developing skin cancer during adulthood, compared to sun exposure in later years,” says the report. 

90 percent of melanomas are caused by UV exposure and are, therefore, eminently preventable. An in-depth report, “The Surgeon General’s Call to Action to Prevent Skin Cancer,” states that to make skin cancer prevention a reality, one needs to increase opportunities for sun protection in outdoor settings and reduce harms from indoor tanning. However, indoor tanning may not be completely applicable to Indian settings and is more suitable for Western nations. Yet, experts agree that childhood sunburn is strongly associated with an increased risk of melanoma during later stages of life. There is thus a pressing need to promote the prevention of harmful ultraviolet exposure through good habits sowed early in life, which are further sustained throughout adulthood for optimal risk reduction.

Also, given that skin cancer is developed over a period of many years of exposure to UV rays, ‘there is no known possibility of secondary prevention efforts through adult skin cancer screening, and hence, effective primary prevention during childhood is key to mitigating risk,’ says the Lancet report. “We must make sure that children are not overexposed to the sun for long periods of time, all through their childhood. This will significantly reduce the possibilities of developing skin cancer in later stages of life,” says Dr Sarla Shah, an oncologist based in suburban Mumbai.  

Although the incidence of skin cancer is relatively lower in India compared to the West, constituting less than 1% of all diagnosed cancers, preventing this type of cancer is crucial in every case. According to a report by scientists from GGS Medical College and Hospital in Faridkot, Punjab, skin cancer is increasingly being diagnosed in the Indian population, despite the protective effects of eumelanin in dark skin.

The researchers conducted a retrospective study in a tertiary hospital in the Malwa area of Punjab to analyse the profile of skin cancer patients who attended the institution over one year, from December 1, 2013, to November 30, 2014. The aim was to identify possible risk factors and environmental factors associated with the high prevalence of skin cancer in the region.

Out of the 2,638 registered cancer patients, skin cancer constituted 3.18% (84 patients). The age of the patients ranged from 27 to 92 years. The most common histological type of skin cancer was basal cell carcinoma (BCC), followed by squamous cell carcinoma and malignant melanoma. The majority of the patients, almost 90%, were from rural areas of Punjab. Furthermore, 92% of the patients were directly involved in agriculture and had a history of prolonged exposure to sunlight.

They found that the head and neck are the most commonly affected areas. It has been reported that exposure to UVB radiation and higher levels of arsenic in drinking water are associated with skin cancers. Additionally, it was found that the levels of arsenic and pesticides in drinking water samples from the Malwa area of Punjab were higher. As a result, it is recommended to implement a multi-faceted approach to ensure the provision of safe drinking water and discourage the indiscriminate use of pesticides.