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Skin cancer: more people die from types that aren’t melanoma – surprise new finding

Non-melanoma skin cancers have often been viewed as fairly benign. A new study undermines that view.

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5 months ago

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If you mention skin cancer, most people think of melanoma – the deadliest skin cancer. The other ones are pretty benign, right?

Not so. Worldwide, more people are now dying of non-melanoma skin cancer (NMSC) than melanoma, a new study has found.

The study, by researchers at the University Hospital of Nice in France, used patient data collected by the International Agency for Research on Cancer (part of the World Health Organization). It showed that while melanoma caused 57,000 deaths globally in 2020, non-melanoma skin cancer accounted for even more, with 63,700 people losing their lives.

In some ways, the study upends conventional wisdom on how much of a threat to life NMSC represents. NMSC is considered to be less serious than other types of cancer – rarely fatal and often left out of national cancer registries’ reports of overall cancer numbers. However, “rarely fatal” is not the same as “never fatal”, and if a sufficiently large number of people develop this type of cancer, then that can add up to a lot of deaths, as this new report shows.

Melanoma and NMSC share some features, with both being closely linked to exposure to ultraviolet radiation (UV) from either the sun or tanning beds. UV is able to produce cancer-causing mutations that drive the formation of both melanoma and NMSC.

The past several decades have seen large increases in the incidence of both types of cancer, as people’s holiday destinations and attitudes to tanning have changed. Most of these cancers occur in white people, but people with darker skin tones can also get skin cancer. Unfortunately, it often goes undiagnosed due to a lack of awareness in both patients and dermatologists.

Melanoma and NMSC do have some important differences, though. While UV is a risk factor for both, NMSC is more associated with chronic exposure throughout a person’s lifetime. Consequently, tumours often arise on the face and head. In contrast, occasional severe sunburns are more closely linked to melanoma, particularly on the trunk.

There are two main types of NMSC: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Both arise from a type of skin cell called a keratinocyte.

Keratinocytes are the main type of cells that make up the epidermis, the outer layer of our skin. Mutations in keratinocytes, caused for example by exposure to UV, can override the internal checks and balances that usually prevent cells from uncontrollably dividing, resulting in a tumour forming.

In contrast, melanomas occur as a consequence of cancer-activating mutations in a different type of skin cell called a melanocyte. There are about ten times fewer melanocytes than keratinocytes in the epidermis, but they play an important role in protecting our skin from damage by producing melanin. Melanin is the pigment that determines our normal skin colour and which is produced in greater amounts after exposure to UV, causing a tan.

Melanoma on light skin
Melanoma is caused by mutations in skin cells called melanocytes. Nasekomoe/Shutterstock

How deaths occur

Most cancer deaths are caused by secondary tumours that arise when cells from the original tumour break away and spread, or metastasise, to distant sites in the body. Skin cancers are no exception. However, metastasis is a very challenging process for cancer cells. They first need to invade surrounding tissue, then survive the stress of transport around the bloodstream before finally being able to establish a colony in an environment that is quite different to the skin.

Melanoma cells are much more effective at achieving all of the steps of metastasis than NMSC cells are. For example, melanoma cells share some characteristics with cells found in the brain and so can readily adapt to the brain as a new environment, forming secondary tumours there.

If it’s the case that NMSC is far less likely to form dangerous secondary tumours, then why is it that it causes more deaths than melanoma? This partly comes down to the numbers involved.

While we have a pretty good idea of how many people across the world get melanoma each year, the numbers for NMSC are much less clear. However, we do know that the current official statistic of 1.2 million cases per year (compared to 325,000 for melanoma) is likely to be a substantial underestimate. This is because of inconsistencies in how data on NMSC cases are gathered and reported between different countries.

These gaps in the data mean that it is quite difficult to get a full picture of trends in the number of cases of NMSC and how likely they are to cause death. Despite this gap, a particularly worrying part of this latest report is its conclusion that where you live in the world has a big impact on how likely you are to survive an NMSC diagnosis.

Like all cancers, the earlier a NMSC can be diagnosed and treated, the better the chance of a positive outcome. It remains to be determined whether a tendency to regard NMSC as relatively innocuous has played any role in this trend, or whether it’s entirely due to other factors such as having ready access to diagnosis and treatment.

An optimistic view

Another, more optimistic, reason for NMSC overtaking melanoma as a cause of cancer death may be the significant progress made in treating melanoma over the past few years.

For example, after decades of increases in the annual number of melanoma deaths, the UK has recently turned a corner and fewer people are now dying, despite the number of cases continuing to rise. This trend is thanks to the availability of a range of new targeted treatments for melanoma that are saving lives every day.

However, prevention is always better than treatment and it’s clear that more still needs to be done to prevent these cancers from occurring in the first place. This can be achieved by ensuring that sun protection messages reach everyone at risk.

Sarah Allinson has previously received funding from North West Cancer Research and Alliance Boots for research on the effects of ultraviolet radiation on skin cells.

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Angry Shouting Aside, Here’s What Biden Is Running On

Angry Shouting Aside, Here’s What Biden Is Running On

Last night, Joe Biden gave an extremely dark, threatening, angry State of the Union…

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2 hours ago

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March 8, 2024

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Angry Shouting Aside, Here's What Biden Is Running On

Last night, Joe Biden gave an extremely dark, threatening, angry State of the Union address - in which he insisted that the American economy is doing better than ever, blamed inflation on 'corporate greed,' and warned that Donald Trump poses an existential threat to the republic.

But in between the angry rhetoric, he also laid out his 2024 election platform - for which additional details will be released on March 11, when the White House sends its proposed budget to Congress.

To that end, Goldman Sachs' Alec Phillips and Tim Krupa have summarized the key points:

Taxes

While railing against billionaires (nothing new there), Biden repeated the claim that anyone making under $400,000 per year won't see an increase in their taxes.  He also proposed a 21% corporate minimum tax, up from 15% on book income outlined in the Inflation Reduction Act (IRA), as well as raising the corporate tax rate from 21% to 28% (which would promptly be passed along to consumers in the form of more inflation). Goldman notes that "Congress is unlikely to consider any of these proposals this year, they would only come into play in a second Biden term, if Democrats also won House and Senate majorities."

Biden also called on Congress to restore the pandemic-era child tax credit.

Immigration

Instead of simply passing a slew of border security Executive Orders like the Trump ones he shredded on day one, Biden repeated the lie that Congress 'needs to act' before he can (translation: send money to Ukraine or the US border will continue to be a sieve).

As immigration comes into even greater focus heading into the election, we continue to expect the Administration to tighten policy (e.g., immigration has surged 20pp the last 7 months to first place with 28% in Gallup’s “most important problem” survey). As such, we estimate the foreign-born contribution to monthly labor force growth will moderate from 110k/month in 2023 to around 70-90k/month in 2024. -GS

Ukraine

Biden, with House Speaker Mike Johnson doing his best impression of a bobble-head, urged Congress to pass additional assistance for Ukraine based entirely on the premise that Russia 'won't stop' there (and would what, trigger article 5 and WW3 no matter what?), despite the fact that Putin explicitly told Tucker Carlson he has no further ambitions, and in fact seeks a settlement.

As Goldman estimates, "While there is still a clear chance that such a deal could come together, for now there is no clear path forward for Ukraine aid in Congress."

China

Biden, forgetting about all the aggressive tariffs, suggested that Trump had been soft on China, and that he will stand up "against China's unfair economic practices" and "for peace and stability across the Taiwan Strait."

Healthcare

Lastly, Biden proposed to expand drug price negotiations to 50 additional drugs each year (an increase from 20 outlined in the IRA), which Goldman said would likely require bipartisan support "even if Democrats controlled Congress and the White House," as such policies would likely be ineligible for the budget "reconciliation" process which has been used in previous years to pass the IRA and other major fiscal party when Congressional margins are just too thin.

So there you have it. With no actual accomplishments to speak of, Biden can only attack Trump, lie, and make empty promises.

Tyler Durden Fri, 03/08/2024 - 18:00

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United Airlines adds new flights to faraway destinations

The airline said that it has been working hard to "find hidden gem destinations."

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9 hours ago

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March 8, 2024

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Since countries started opening up after the pandemic in 2021 and 2022, airlines have been seeing demand soar not just for major global cities and popular routes but also for farther-away destinations.

Numerous reports, including a recent TripAdvisor survey of trending destinations, showed that there has been a rise in U.S. traveler interest in Asian countries such as Japan, South Korea and Vietnam as well as growing tourism traction in off-the-beaten-path European countries such as Slovenia, Estonia and Montenegro.

Related: 'No more flying for you': Travel agency sounds alarm over risk of 'carbon passports'

As a result, airlines have been looking at their networks to include more faraway destinations as well as smaller cities that are growing increasingly popular with tourists and may not be served by their competitors.

The Philippines has been popular among tourists in recent years.

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United brings back more routes, says it is committed to 'finding hidden gems'

This week, United Airlines  (UAL)  announced that it will be launching a new route from Newark Liberty International Airport (EWR) to Morocco's Marrakesh. While it is only the country's fourth-largest city, Marrakesh is a particularly popular place for tourists to seek out the sights and experiences that many associate with the country — colorful souks, gardens with ornate architecture and mosques from the Moorish period.

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"We have consistently been ahead of the curve in finding hidden gem destinations for our customers to explore and remain committed to providing the most unique slate of travel options for their adventures abroad," United's SVP of Global Network Planning Patrick Quayle, said in a press statement.

The new route will launch on Oct. 24 and take place three times a week on a Boeing 767-300ER  (BA)  plane that is equipped with 46 Polaris business class and 22 Premium Plus seats. The plane choice was a way to reach a luxury customer customer looking to start their holiday in Marrakesh in the plane.

Along with the new Morocco route, United is also launching a flight between Houston (IAH) and Colombia's Medellín on Oct. 27 as well as a route between Tokyo and Cebu in the Philippines on July 31 — the latter is known as a "fifth freedom" flight in which the airline flies to the larger hub from the mainland U.S. and then goes on to smaller Asian city popular with tourists after some travelers get off (and others get on) in Tokyo.

United's network expansion includes new 'fifth freedom' flight

In the fall of 2023, United became the first U.S. airline to fly to the Philippines with a new Manila-San Francisco flight. It has expanded its service to Asia from different U.S. cities earlier last year. Cebu has been on its radar amid growing tourist interest in the region known for marine parks, rainforests and Spanish-style architecture.

With the summer coming up, United also announced that it plans to run its current flights to Hong Kong, Seoul, and Portugal's Porto more frequently at different points of the week and reach four weekly flights between Los Angeles and Shanghai by August 29.

"This is your normal, exciting network planning team back in action," Quayle told travel website The Points Guy of the airline's plans for the new routes.

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Walmart launches clever answer to Target’s new membership program

The retail superstore is adding a new feature to its Walmart+ plan — and customers will be happy.

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9 hours ago

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March 8, 2024

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It's just been a few days since Target  (TGT)  launched its new Target Circle 360 paid membership plan. 

The plan offers free and fast shipping on many products to customers, initially for $49 a year and then $99 after the initial promotional signup period. It promises to be a success, since many Target customers are loyal to the brand and will go out of their way to shop at one instead of at its two larger peers, Walmart and Amazon.

Related: Walmart makes a major price cut that will delight customers

And stop us if this sounds familiar: Target will rely on its more than 2,000 stores to act as fulfillment hubs. 

This model is a proven winner; Walmart also uses its more than 4,600 stores as fulfillment and shipping locations to get orders to customers as soon as possible.

Sometimes, this means shipping goods from the nearest warehouse. But if a desired product is in-store and closer to a customer, it reduces miles on the road and delivery time. It's a kind of logistical magic that makes any efficiency lover's (or retail nerd's) heart go pitter patter. 

Walmart rolls out answer to Target's new membership tier

Walmart has certainly had more time than Target to develop and work out the kinks in Walmart+. It first launched the paid membership in 2020 during the height of the pandemic, when many shoppers sheltered at home but still required many staples they might ordinarily pick up at a Walmart, like cleaning supplies, personal-care products, pantry goods and, of course, toilet paper. 

It also undercut Amazon  (AMZN)  Prime, which costs customers $139 a year for free and fast shipping (plus several other benefits including access to its streaming service, Amazon Prime Video). 

Walmart+ costs $98 a year, which also gets you free and speedy delivery, plus access to a Paramount+ streaming subscription, fuel savings, and more. 

An employee at a Merida, Mexico, Walmart. (Photo by Jeffrey Greenberg/Universal Images Group via Getty Images)

Jeff Greenberg/Getty Images

If that's not enough to tempt you, however, Walmart+ just added a new benefit to its membership program, ostensibly to compete directly with something Target now has: ultrafast delivery. 

Target Circle 360 particularly attracts customers with free same-day delivery for select orders over $35 and as little as one-hour delivery on select items. Target executes this through its Shipt subsidiary.

We've seen this lightning-fast delivery speed only in snippets from Amazon, the king of delivery efficiency. Who better to take on Target, though, than Walmart, which is using a similar store-as-fulfillment-center model? 

"Walmart is stepping up to save our customers even more time with our latest delivery offering: Express On-Demand Early Morning Delivery," Walmart said in a statement, just a day after Target Circle 360 launched. "Starting at 6 a.m., earlier than ever before, customers can enjoy the convenience of On-Demand delivery."

Walmart  (WMT)  clearly sees consumers' desire for near-instant delivery, which obviously saves time and trips to the store. Rather than waiting a day for your order to show up, it might be on your doorstep when you wake up. 

Consumers also tend to spend more money when they shop online, and they remain stickier as paying annual members. So, to a growing number of retail giants, almost instant gratification like this seems like something worth striving for.

Related: Veteran fund manager picks favorite stocks for 2024

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