Special Report: Skin Cancer

It was a hot July day in Amagansett, N.Y., and the noonday sun glared down at a crowded Long Island beach. Perched atop his observation stand, a bronzed lifeguard, hatless and clad only in abbreviated trunks, kept close watch on the few dozen waders and swimmers braving the still frigid waters of the Atlantic Ocean. Around him, hundreds of sunbathers sprawled on the sand. Some, mostly older, shielded themselves from the sun's fierce rays under broad- brimmed hats and umbrellas. But much of the crowd baked contentedly in the sunlight, wearing only scanty swimsuits and little or no sunscreen. At the water's edge, tots played in the sand, some with backs and arms alarmingly red.

Across the U.S. last week, this scene was repeated as millions of people, still unaware of the odds against them, continued to play a game of solar roulette. Those odds are worsening at an alarming rate. The American Cancer Society predicts that in the U.S. this year, more than 600,000 new cases of skin malignancies will be diagnosed, most of them caused by excessive exposure to ultraviolet rays from the sun. Some 27,600 of those cases will be malignant melanoma, the deadliest type, which has been increasing 7% annually over the past decade and will kill 6,300 people this year. Most of the other skin cancers will be basal-cell and squamous-cell carcinomas, less lethal but still dangerous if not treated in time. Some 2,500 victims of these cancers (mostly squamous cell) will die this year, and most of the others will undergo surgery, generally minor but occasionally disfiguring.

Doctors are particularly struck by the rise in melanoma cases. "When I went into practice 25 years ago," says Dr. Henriette Abel, "if I saw one melanoma a year, it was a big deal." This year, however, "there was a period when I saw six in six weeks." Her brother Dr. Robert Abel, with whom she shares a dermatology practice in Elizabeth, N.J., now diagnoses an average of one melanoma case a month.

Experts attribute the growing onslaught of skin cancer to the new affluence of Americans in the years after World War II. That was when they began taking vacations in the Sunbelt and the Caribbean; adopting the sun-worshiping culture, as well as the music, of the Beach Boys; and jogging endlessly in skimpy clothes. Because the effects of sunlight on the skin are cumulative and usually require years of exposure before malignancy begins, the results are just showing up now. The Harvard Medical School Health Letter has neatly summarized the situation: "The bronzed youth of the baby boom, now reaching middle age, are in the vanguard of the melanoma plague."

Greater danger may lie ahead. Some have suggested that depletion of the ozone layer, which blocks much of the sun's ultraviolet radiation, is contributing to the rise in skin cancer. While there is little evidence to support this notion, scientists agree that in the long run a diminished ozone layer will cause trouble. "Decreased ozone will increase numbers of basal- and squamous-cell carcinomas," says Dr. Stanford Lamberg, a Johns Hopkins dermatologist. "There is no question about that."