Black Patients Face Deadly Delays in Skin Cancer Diagnosis
Racial disparities in dermatology are costing lives. Here’s why — and what needs to change.
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Despite medical advancements, not all patients benefit equally. One of the clearest examples of this inequity is in the diagnosis and treatment of skin cancer — especially among Black patients. For far too long, skin cancers in people with darker skin tones have gone undetected or misdiagnosed, often with deadly consequences.
The Deadly Delay
Skin cancer, particularly melanoma, is far less common in Black individuals than in white populations. But when it does occur, it’s often far more lethal. According to the American Academy of Dermatology, the five-year melanoma survival rate for Black patients is only 66%, compared to 92% for white patients.
Why the gap? One of the key reasons is late diagnosis. Many Black patients are diagnosed at a later stage, when the cancer has already advanced and treatment is more difficult.
Why Is Skin Cancer Overlooked in Black Patients?
Several factors contribute to this disparity:
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Medical Training Bias: Many dermatology textbooks and training programs primarily focus on how skin conditions appear on white skin. As a result, medical professionals may struggle to recognize skin cancer symptoms on darker skin.
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Underrepresentation in Research: Clinical trials and studies on skin cancer often lack diverse participants, leading to limited knowledge about how these cancers present in people of color.
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Assumption of Low Risk: There’s a persistent (and misleading) belief that Black people are at low or no risk for skin cancer. While melanin does offer some natural protection against UV damage, it does not make someone immune to skin cancer.
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Access to Care: Black patients are more likely to face barriers to dermatological care, including lack of insurance, fewer dermatologists in predominantly Black communities, and mistrust in the healthcare system due to historical mistreatment.
What Does Skin Cancer Look Like on Black Skin?
Melanoma in Black individuals often appears in less sun-exposed areas, such as:
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Palms of the hands
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Soles of the feet
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Under the nails (a type called acral lentiginous melanoma)
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Mucous membranes (like inside the mouth or genitals)
These unusual locations can lead to further delays in detection, as both patients and doctors may not think to check them.
Real Lives at Risk
Consider the case of Bob Marley, the reggae legend who died at age 36 from acral lentiginous melanoma. His skin cancer began under a toenail — a location rarely associated with skin cancer in public awareness campaigns, especially for Black patients. His story is a tragic reminder of the consequences of delayed diagnosis.
What Needs to Change
Fixing this disparity will take commitment at every level of the healthcare system:
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Diverse Medical Education: Dermatology programs must include images and case studies of skin conditions on all skin tones.
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Public Awareness Campaigns: Outreach specifically aimed at communities of color can help encourage earlier skin checks and medical visits.
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Better Access to Dermatologists: Telehealth, mobile clinics, and increased funding for underserved areas can improve early detection.
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Empowering Patients: People with darker skin should be encouraged to do monthly skin self-checks — including on palms, soles, and nail beds — and report any unusual changes.
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More Inclusive Research: Clinical trials must better represent people of color to ensure that findings apply to all populations.
Your Skin Tells a Story — Listen to It
Early detection saves lives. While skin cancer is often viewed as a “white person’s disease,” that dangerous myth continues to cost Black patients dearly. By raising awareness, pushing for medical reform, and ensuring inclusive care, we can help close this deadly gap.
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