Skin Cancer: 4 Reasons You're at Risk

1. You assume your doctor is looking out for suspicious moles.

Maybe you're good about avoiding the sun at its strongest. Maybe you don't intentionally fry anymore. Whatever your rationale, you may think skin cancer is other people's problem (particularly George Hamilton types who winter in Palm Springs). Yet skin cancer is not only the most common cancer in the country -- there are more than 1.3 million new cases a year -- its numbers have been rising for several decades. Here, the common mistakes women make.

1. You assume your doctor is looking out for suspicious moles. Don't. If your primary-care physician takes her cues from the U.S. Preventive Services Task Force, a leading authority for screening tests, she may not do a full-body skin exam during a routine checkup. This could be the case even if you've got risk factors for skin cancer -- you're fair or have freckles, you have many moles, you had a lot of sun exposure as a child or you have a personal or family history of skin cancer. In a national study, Alan Geller, MPH, an associate professor of dermatology at Boston University School of Medicine, found that 41 percent of internists and general practitioners do not routinely do skin exams on their high-risk patients. (Your doctor is more likely to be annually scanning your skin if she follows the recommendations of the American Cancer Society, the American Academy of Dermatology, or the American College of Obstetricians and Gynecologists.) If your doctor doesn't check your skin, ask her to. Either she'll do it, or she'll refer you to a dermatologist for a more thorough exam.

2. You love being an athlete, but you're not so great about using sunscreen.

"Our research shows that athletes don't put it on most commonly because they simply forget," says Philip Cohen, MD, assistant team physician at Rutgers University Sports Medicine in Piscataway, New Jersey. If you do remember the sunblock, you probably don't reapply it. "Yet anyone who plays or trains in the sun -- golfers, tennis players, swimmers -- is at greater risk, since sun exposure is responsible for most skin cancer," says Karen Burke, MD, PhD, a dermatologist and research scientist at Mount Sinai Medical Center in New York City. Compounding the damage that extended time in the sun does is the fact that water, snow, concrete, and sand all reflect ultraviolet rays, so the same rays hit you twice, increasing harmful exposure by as much as 25 to 90 percent.

3. You've gotten a "base" tan from a sunlamp or at a tanning salon.

"There is no healthy tan," Dr. Burke states emphatically. "To have one, even a light one, is to have skin damaged by UV, so you are less able to fight off skin cancer." More alarming: If you used tanning parlors as a teen or in your 20s, your risk for melanoma spikes 75 percent, says the World Health Organization. Artificial tanning as a teen also increases your risk for squamous cell cancer.

4. You don't take a sunburn seriously.

In a FITNESS survey, 35 percent of women said that they had gotten sunburned within the last year. Add to that the 38 percent who report having sunburns in the past five years and that means a whopping 73 percent aren't taking good enough care to protect their skin from the sun. And in this case, there's no safety in numbers. Having just five sunburns in your lifetime will double your risk for skin cancer, and having had just one blistering sunburn as a child will double your chances for deadly melanoma.

Do-It-Yourself Skin Exam

In an exclusive FITNESS poll, only 22 percent of women say they check themselves the recommended once a month, while almost half say they never examine themselves, and don't know how. Yet a skin exam is just a visual check. See how easy it is with this step-by-step guide based on recommendations from the Skin Cancer Foundation.

1. Get naked.
2. Look for any new moles or those that appear different from the others. Of preexisting moles, watch out for the "ABCDE's" of melanoma: asymmetry, border irregularity, color that's uneven, diameters bigger than 6 millimeters, and evolution, meaning the mole has changed in any way.

Examine every inch of your body, paying special attention to your legs, the most common site for melanoma in women, plus areas exposed to the sun, like face, hands, and shoulders, the most common sites for nonmelanoma cancer. (Use a mirror for your back, or ask your partner for help.)

Be sure to check "down there" for any dark bumps or flat and mottled spots. Because skin cancer in the genital area is frequently missed, it's one of the deadliest.

If you find anything suspicious, call your doctor, who will either have you come in or refer you to a dermatologist. Even if you don't find anything, you now have a baseline sense of the moles on your body; moving forward, you will know when a new one pops up or an old one changes.

Is it benign or is it skin cancer? Check out our illustrated guide to basal cell carcinoma, squamous cell carcinoma, and melanoma.

Originally published in FITNESS magazine, May 2007.