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Quick answer: Skin cancer is the most common cancer in the United States, and a widely cited estimate is that about 1 in 5 Americans will develop it by age 70. Most cases are treatable when found early. The warning sign that matters most is a new spot, or a spot that is changing in size, shape or color. Use the ABCDE checklist for moles, look over your skin regularly, and see a clinician about anything new or changing. Daily broad-spectrum SPF 30 or higher sunscreen, shade and clothing are the best-supported prevention.
How common is skin cancer?
The “1 in 5 by age 70” figure appears on the Skin Cancer Foundation’s site and elsewhere. Its underlying data come from older US estimates, so treat it as a long-standing approximation rather than a precise current rate. Lifetime melanoma risk also differs by group, estimated at about 2.6% for White people, 0.6% for Hispanic people and 0.1% for Black people, though people of all skin tones can get skin cancer, and when it occurs in darker skin it is often found later.
Risk climbs with age because sun damage accumulates over decades. Other risk factors include fair skin, many moles, a history of sunburns or tanning bed use, a weakened immune system, and a personal or family history of skin cancer.
The three main types
- Basal cell carcinoma: the most common. Often a pearly or waxy bump, a flat flesh-colored patch, or a sore that bleeds and does not heal. It grows slowly and rarely spreads, but it can damage nearby tissue.
- Squamous cell carcinoma: often a scaly red patch, a rough crusted bump or a sore that persists, especially on sun-exposed areas such as the face, ears, hands and lips. It is more likely than basal cell to spread if left untreated.
- Melanoma: less common but more dangerous because it can spread. It may arise from an existing mole or appear as a new dark spot.
The ABCDE rule for moles
This checklist was created as a teaching aid to help people spot early melanoma. A mole with one or more of these features deserves a professional look:
- A: Asymmetry. One half does not match the other.
- B: Border. Edges are ragged, notched or blurred.
- C: Color. Several colors, such as brown, black, tan, red, white or blue, in one mole.
- D: Diameter. Larger than about 6 mm (roughly a pencil eraser), though melanomas can be smaller.
- E: Evolving. Any change in size, shape, color, height, or new symptoms such as itching, tenderness or bleeding.
The American Cancer Society describes the most important sign as a new spot or one that is changing. A mole that looks different from the rest, the “ugly duckling,” is another useful clue. Non-melanoma cancers do not always follow ABCDE, so any sore that does not heal in a few weeks should be checked.
How to do a skin self-check
- Pick a monthly date and stand in a well-lit room in front of a full-length mirror
- Check your face, scalp (use a comb or ask a partner), ears and neck
- Look at the front and back of your torso and both sides of your arms, including the underarms
- Check your hands, between the fingers, and under the nails
- Check your legs, the tops and soles of your feet, between the toes and your genitals
- Use a hand mirror for your back, or ask someone else to look
- Take photos of any spot you want to track so you can compare later
It is worth being honest about the evidence. Monthly self-exams are commonly recommended, but there is limited data that they reduce deaths, and the US Preventive Services Task Force (2023) concluded that the evidence is insufficient to recommend for or against routine visual skin exams by a clinician in people without symptoms. That is not the same as saying exams are useless. It means the benefit has not been proven in trials, and the task force says clinicians should use judgment. People with a personal or family history, many moles, or any suspicious spot should not wait for screening and should be examined.
When to see a dermatologist
- A mole or spot that is new, changing or looks different from the others
- A sore that bleeds, crusts or does not heal in three to four weeks
- A scaly patch that persists or a rough bump that grows
- A dark streak under a nail not caused by an injury
- You have a personal or family history of melanoma or many atypical moles
A dermatologist may examine the spot with a magnifier and, if needed, take a small sample (biopsy). Treatment depends on the type and stage, and ranges from minor removal to more advanced therapy for melanoma.
Prevention that actually has support
The American Academy of Dermatology recommends broad-spectrum sunscreen with SPF 30 or higher that is water resistant, along with seeking shade and wearing protective clothing, a wide-brimmed hat and sunglasses. Use of sunscreen matters: typical users apply much less than was used in lab testing, and so get only a fraction of the labeled protection. Apply generously about 15 minutes before going out, cover often-missed areas such as ears, the back of the neck, hands, the tops of feet and bald spots, and reapply roughly every two hours or after swimming or sweating. A broad-spectrum SPF 30 sunscreen is a reasonable starting point; the best product is one you will use daily.
What about vitamin D?
Some people worry that sun protection leads to low vitamin D. Dermatology groups generally recommend getting vitamin D from food and supplements rather than from unprotected sun or tanning beds. If you are concerned about your level, ask for a blood test, and read our guide to vitamin D supplements for bone health after 50.
Skin changes that are usually harmless
Not every spot is cancer. After 50 many people develop seborrheic keratoses (waxy, “stuck-on” brown growths), cherry angiomas (small red dots) and age spots from sun exposure. Dry, rough skin is also common; see why skin gets drier after 60. Persistent facial redness may be rosacea rather than sun damage; see rosacea after 50. If you are not sure, getting a spot checked is the safest approach.
The bottom line
Skin cancer is common after 50 and usually very treatable when caught early. Look over your skin regularly, use the ABCDE rule, photograph anything you want to track, and get any new, changing or non-healing spot examined. Sunscreen, shade and clothing are the proven prevention. This information is general and not a substitute for medical advice.
Sources: US Preventive Services Task Force statement on skin cancer screening (2023); American Academy of Dermatology sunscreen guidance; American Cancer Society melanoma warning signs; Skin Cancer Foundation statistics.
Frequently asked questions
What are the ABCDE signs of melanoma?
Asymmetry, irregular Border, uneven Color, Diameter larger than about 6 mm, and Evolving, meaning any change in size, shape, color or symptoms. Any mole with one or more of these features should be checked by a clinician.
How often should I check my skin?
Monthly self-checks are commonly recommended, though evidence that they reduce deaths is limited. People with a personal or family history, many moles or a suspicious spot should be examined by a clinician instead of waiting.
Does the USPSTF recommend routine skin cancer screening?
The USPSTF (2023) concluded that evidence is insufficient to recommend for or against visual skin examination by a clinician in people without symptoms. It does not apply to people with symptoms or a personal or family history.
What SPF should I use?
The American Academy of Dermatology recommends broad-spectrum, water-resistant sunscreen with SPF 30 or higher, combined with shade and protective clothing.
Can skin cancer appear on darker skin?
Yes. Melanoma is less common in people with darker skin but can occur and is often found later, sometimes on the palms, soles or under the nails.
Part of our Skin and Hair After 50: The Complete Guide.