New research from Huntsman Cancer Institute at the University of Utah published in Surgical Clinics of North America shows that some people are more likely to face delays and worse outcomes from dangerous types of skin cancer. These groups include older adults, people living in rural areas, and those who have trouble getting regular medical care.
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The review focuses on the most serious forms of skin cancer, including melanoma, Merkel cell carcinoma (MCC), and advanced squamous and basal cell skin cancers. While these cancers can often be treated successfully if caught early, not everyone has the same chance of early diagnosis or access to the latest treatments.
The paper is published in the journal Surgical Clinics of North America.
Key findings from the review include:
- Older adults have the highest death rates from aggressive skin cancers, but they are less likely to receive standard-of-care treatments. This may be due to other competing health conditions, difficulty getting to appointments, or not noticing skin changes early on.
- People in rural communities often face long travel times to see a dermatologist or cancer specialist. They may also have less access to skin cancer education and prevention tools like sunscreen or skin checks.
- Some patients aren’t diagnosed until the cancer is advanced. This often happens when people don’t know the signs of skin cancer, they don’t have a regular doctor, the cancer is located in an area where they cannot see, such as the bottom of their feet, or they aren’t used to getting screened.
“High-risk skin cancers don’t affect everyone the same way. To save lives, we need to understand who’s being left behind—and why,” said Elliot Asare, MD, MS, CMQ, FACS, Surgical oncologist at Huntsman Cancer Institute and lead author of the review.
Why age matters
Most cases of melanoma are diagnosed in people over 55 with about 11% of cases occurring in people under age 45. There are about 3,000 cases per year of MCC in the United States, and it commonly occurs in those over 65.
Even though Medicare provides insurance at 65, many older patients still face barriers like poor health, trouble getting around, or a lack of help from family or caregivers. The review found that older adults are also less likely to be offered adequate surgery or newer treatments like immunotherapy when needed.
Why location matters
People who live far from big cities often don’t have easy access to skin cancer experts. They’re also less likely to use sunscreen or get regular skin checks. Research shows rural residents are more likely to use tanning beds and are more often diagnosed at later stages, when treatment is harder and outcomes are worse.
Steps to improve skin cancer care
The review offers several ways to help more people get timely care:
- Making telehealth visits more widely available
- Making it easier to qualify for clinical trials
- Teaching the public about skin cancer risks and what to look for
- Encouraging patients to pay attention to lesions on their skin, or that of family members, that look concerning so that they can get it evaluated quickly
- Training health care providers to recognize skin cancer on all skin tones
While progress is being made, the review calls for new strategies that focus on the people most at risk of being overlooked.
Huntsman Cancer Institute is taking action by expanding access to care through telehealth, outreach, and education, especially in rural and underserved areas. Huntsman Cancer Institute is also expanding access to lifesaving screening and treatment with a new Comprehensive Cancer Center in Vineyard, Utah County.
“Cancer care shouldn’t be one-size-fits-all,” says Asare. “We need to meet patients where they are, and make sure everyone has a fair chance at early diagnosis and the best care possible.”
