When people of color are diagnosed with melanoma, it’s often at more advanced stages and associated with lower rates of survival. Lack of awareness about melanoma risk, as well as underrepresentation in research, contributes to this disparity.

Melanoma is a type of skin cancer that develops in melanocytes, the cells that give skin its pigmentation. While commonly caused by exposure to ultraviolet (UV) radiation, melanomas can also develop from genetic mutations unrelated to the time you spend in the sun or tanning facilities.

People with lighter skin color have a higher risk for melanoma, and among those with lighter skin color, having light hair and eye color increases the risk further.

Although white people are more likely to develop melanoma in the first place, people of color are more likely to have negative outcomes, including poorer survival rates. They’re also more likely to be diagnosed with advanced forms of skin cancer.

Metastasis is the spread of cancer cells to distant sites beyond their point of origin. Metastatic melanoma refers to advanced-stage melanoma, or stage 4 melanoma, indicating that cancer has spread to other areas of the body.

According to the Melanoma Research Alliance, people of color are 4 times more likely to be diagnosed with advanced-stage melanoma compared to white people and are 1.5 times more likely to die from this type of skin cancer.

Other melanoma statistics that relate to skin color include the following:

  • Black people diagnosed with melanoma have an estimated 5-year survival rate of 71%, compared to a 94% 5-year survival rate for white people.
  • In people of color, melanoma is more likely to develop in areas that get little sun exposure, such as the soles of the feet or palms of the hands.
  • As many as 75% of melanomas in people of color develop on the soles of the feet, palms, or in and around the nail area.

Overall, people of color are less likely to develop melanoma compared to white people.

Having lighter skin is associated with lower levels of melanin, the pigment produced by melanocytes.

Melanin protects the body against UV radiation. The more melanin you have, the darker your skin and the better your body absorbs and neutralizes the effects of UV rays. This also means people with light skin are more likely to burn rather than tan, and it takes less time in the sun for them to experience negative effects.

Despite lower rates of melanoma overall, people of color experience higher rates of metastatic disease at the time of diagnosis. More advanced disease contributes to higher mortality rates.

Several factors may influence this, including lack of awareness about melanoma risk, differences in common clinical signs, and a lack of inclusive research.

Melanoma risk

Anyone of any skin color can develop melanoma. Due to the protective nature of darker skin when it comes to sun exposure, however, many people of color may not be aware they still have a cancer risk.

This assumption can mean people use less sunscreen, for instance, or that they delay seeking treatment until cancer has spread and symptoms become more obvious and debilitating.

Differences in clinical signs

Melanoma can also present uniquely in people of color.

White people are more likely to develop melanoma on the chest, back, face, neck, and legs, while people of color are more likely to develop melanoma on the undersides of the hands, feet, and around nail areas, where there is less melanin.

This can increase the chances skin cancer goes undetected longer or is attributed to other noncancerous skin conditions.

Lack of inclusive research

According to a scientific paper from 2023, the lack of inclusive research about melanoma among people of color also contributes to higher rates of metastatic disease. Without proper representation in research, melanoma among people of color remains underrepresented in educational literature, which means it is understudied in many dermatological programs.

This may lead to dermatologists unfamiliar with how melanoma presents on darker skin, not recognizing its clinical signs efficiently, leading to a later (and more serious) diagnosis.

Health inequity

People of color often face health inequities, unjust and preventable differences in health-related outcomes and access to care. Many factors can contribute to a general state of health inequity, including:

  • limited access to quality healthcare
  • language barriers
  • poverty
  • food insecurity
  • housing insecurity
  • limited access to education
  • exposure to discrimination and racism
  • living in unsafe neighborhoods
  • not having health insurance
  • being without transportation

These factors can all impact the ability to seek timely diagnosis and treatment of metastatic melanoma.

Improving disparities in metastatic melanoma among people of color starts with addressing underlying issues related to education, awareness, and health inequity.

Mandating inclusive research, improving inclusive dermatology training, and developing community melanoma awareness programs are just a few examples of initiatives that could make a difference.

Efforts to improve health equity overall for people of color can also help. This includes:

  • national and local policy reform
  • community-based advocacy and support programs
  • cultural training for healthcare providers
  • increasing access to health education
  • expanding healthcare in underserved areas

No matter the color of your skin, the American Academy of Dermatology Association indicates you can reduce your risk for developing skin cancers like melanoma by:

  • avoiding tanning beds or sunlamps
  • wearing clothes that shield skin from the sun — including on the soles of feet
  • staying in shaded areas when outside
  • applying sunscreen 15–30 minutes before going outside
  • wearing water-resistant sunscreen SPF 30 or higher
  • reapplying sunscreen every 2 hours or after sweating or swimming
  • conducting a monthly, full-body self-examination for any skin changes

Speak with a dermatologist any time you notice:

  • a changing growth or spot on your skin
  • a new dry, scaly patch of skin
  • a dark streak or line in and around your nails
  • a sore that won’t heal or heals and then returns
  • bleeding or itching associated with a growth, mole, or discolored spot

Melanoma is a type of skin cancer affecting people of all skin types and colors. While it’s more common among white people, melanoma is more likely to be diagnosed in the advanced stages (metastatic melanoma) when found in people of color.

Increasing awareness about melanoma risk, as well as focusing on inclusive research efforts and health equity, can help improve this disparity in skin cancer outcomes.