JULY 19, 2022 – Some soldiers have a greater risk for developing skin cancer than others. For July’s UV Safety Awareness month, soldiers should be aware of their risks and how to reduce their chances of skin cancer.
Cancer, including skin cancer, is one of various chronic diseases monitored in the active-duty Army population in the Army Public Health Center’s annual Health of the Force report. Skin cancer is an especially preventable disease because ultraviolet radiation exposure – mostly from the sun and tanning beds – is the primary cause.
The National Institutes of Health divides skin cancer into two groups: melanoma and non-melanoma.
Melanoma is the least common but most serious form of skin cancer. Most skin cancer deaths are caused by melanoma, which can occur anywhere on the body, including areas that are never exposed to ultraviolet radiation. If not treated in time, melanomas are likely to spread to other parts of the body.
Non-melanoma skin cancers include basal cell and squamous cell. These forms of skin cancer are much more common but less severe. They typically occur on areas of the body that have been exposed to UV radiation.
The damage caused by UV radiation builds over time, so more frequent exposures during a lifetime will increase the risk of developing skin cancer. Evidence also suggests that shorter intermittent periods of high-intensity exposures – such as during military deployments to areas of intense sunlight – may be especially dangerous.
Based on the Health of the Force analysis, “Cancer diagnoses are actually relatively rare in our active-duty force,” says Dr. Alexis Maule, an APHC senior epidemiologist. “This is expected in a younger-age population.”
Rare incidence of skin cancer may not be the case as a soldier ages, however. A scientific review published in the June 2018 Journal of the American Academy of Dermatology identified “an abundance of evidence for an increased risk for skin cancer development among U.S. veteran populations.”
“While skin cancer may not be a concern to you during your active-duty years, some of your most serious sun exposures may occur as a soldier,” says Dr. Chip McCannon, a medical doctor and retired Navy preventive medicine officer working for the APHC’s Clinical Public Health and Epidemiology Directorate. “To reduce your risk of developing this serious health condition after you’ve separated or retired from military service, you should minimize your UV exposures while you’re younger.”
According to the National Cancer Institute of the NIH, skin cancers are among the top five forms of cancer experienced in the United States. The risks are highest among white males over 50 years of age, the average age being 65 years.
Since outdoor work has been associated with higher risk of exposure to UV radiation, occupations such as construction workers, farmers, lifeguards, and even postal workers are among those who have been found to have higher skin cancer risk.
The review of skin cancer among military personnel found that due to periodic deployments to locations of intense UV radiation exposure, service members may be in an even higher risk category than occupations where regular daily sun exposure occurs.
For example, during Operation Enduring Freedom and Operation Iraqi Freedom, personnel were often deployed multiple times, with average lengths of deployment ranging from 4.5 months for the Army to 9.4 months for the Air Force. The intensity and repeated nature of UV exposure during these deployments could pose a greater risk of the development of melanoma or non-melanoma skin cancer among deployed service members.
The review concluded that for many service members who had worked in high-UV-exposure environments, sun protection had not been a priority. Immediate operational and combat safety concerns took precedence. Findings also noted the inability to avoid peak sunlight hours during missions; continued exposure to highly reflective surfaces, such as sand; little to no emphasis on sun protection; and limited access to sunscreen.
While the APHC provides Army guidance for reducing sun exposures, everyone should aim to reduce overall UV exposures by:
- Never using tanning beds.
- Minimizing exposure to intense outdoor UV radiation by exercising indoors or exercising in the early morning or late evening.
- Wearing clothing as a barrier to skin exposed to sunlight.
- Wearing hats (ideally wide-brimmed).
- Wearing sunglasses.
- Regularly using sunscreen with SPF 30 or above and reapplying it at least every 2 hours or after the skin has been wet. Apply sunscreen to exposed areas such as your face, neck, hands, and arms. Remember that UV exposure can be from reflective surfaces, such as snow, water, and sand; and UV rays can reach you on cloudy days, too.
McCannon says that in addition to the risk from UV radiation, it’s important to be aware of personal characteristics that may increase your risk, such as being light-skinned, having had a serious blistering sunburn or multiple sunburns in the past, or if you or a family member has had skin cancer previously. Men are at potentially higher risk because they use sunscreen less, are less likely to have their skin checked, and may experience longer exposure durations while participating in outdoor recreational and occupational activities.
The U.S. Preventive Medicine Task Force does not consider annual medical skin cancer screening examinations necessary for all adults, but since some U.S. military personnel have been found to have higher rates of skin cancer than civilians, soldiers with additional risk factors should talk about their skin health with their healthcare provider. This is especially important if you notice a new or changing mole or unusual spot on the skin.
The good news is that with early detection, skin cancers can be treated. The Veterans Administration offers tips on what to look for and when to seek medical attention. This can be found at https://www.va.gov/WHOLEHEALTHLIBRARY/tools/skin-cancer.asp.
Remember to protect your skin daily – not just in summer but throughout the year.
The U.S. Army Public Health Center focuses on promoting healthy people, communities, animals, and workplaces through the prevention of disease, injury, and disability of Soldiers, retirees, family members, veterans, Army civilian employees, and animals through population-based monitoring, investigations, and technical consultations.
NOTE: The mention of any non-federal entity and/or its products is for informational purposes only, and not to be construed or interpreted, in any manner, as federal endorsement of that non-federal entity or its products.
By V. Hauschild, MPH
U.S. Army Public Health Center