Another sun-baked summer day, and at the Bethesda community pool, there was no paucity of sun worshipers. Among them: Lori Mininger, a 23-year-old who admitted she knew better. She knows about the risks of skin cancer, knows about the A-B-C-D signs of melanoma, the most dangerous kind of skin cancer around. And yet there she was, stretched out on her fuchsia-orange-and-green-striped towel for a few more hours of soaking up rays.
Without even a dot of sunscreen. Her skin, tan and abundant with freckles, was glowing.
"I know I should put some on," Mininger, just a couple weeks past a bad Fourth of July burn, confessed with a sheepish smile.
Dermatologists say and studies confirm that Mininger has plenty of company, especially among teenagers and twenty-somethings. With this crowd especially, warnings about the deleterious effects of exposure to ultraviolet rays -- whether the natural kind or that found in tanning salons -- still pale in comparison to fashion's images of bronzed bodies.
A study several years ago by the American Cancer Society concluded that more than two-thirds of people ages 11 to 18 took no precautions in the sun. Another found that more than seven in 10 youths had been sunburned during the summer.
Melanoma's symptoms have long been relayed via user-friendly alphabet clues -- A (asymmetrical areas of a mole, lesion or skin growth), B (irregular borders), C (color variation, especially darkening browns to black) and D (diameter bigger than that of a pencil eraser).
"We really have lots of work to be done on prevention," said Vilma Cokkinides, program director of risk factor surveillance for the American Cancer Society, who said she is awaiting updated youth data with some trepidation. "Unfortunately, we haven't really changed that social mindset."
The repercussions show up in statistics. Most skin cancer is the result of the accumulated insult of sun exposure over time, with severe sunburning early in life being one of the key risk factors. Incidence rates of melanoma continue to rise in the United States: More than 59,500 new cases are projected this year, compared with 38,300 a decade ago. According to the National Institutes of Health, melanoma is the leading cause of cancer death among women ages 25 to 30.
"We are seeing lots of young people with melanoma," said Michael Todd, a dermatologist with the Skin Cancer Center of Northern Virginia. "It's actually scared me quite a bit."
The tragedy, he and others said, is that skin cancer is so preventable and that melanoma, which accounts for about three-fourths of deaths, is highly curable if detected early. "If caught late," Todd said, "it's lethal."
If there is progress, it's among preadolescents. They are growing up with increasing messages about skin cancer in school health classes, with parents who are increasingly insisting on sunscreen (even if they don't put any on themselves) and are bringing their children in for skin checks, Todd said. "It's like seat belts," he said. Grow up slathering, and, like buckling up, the practice becomes ingrained.
Or something personal happens.
For Sam Read, 17, the something has been working this summer at the Bethesda pool. The staff keeps a big supply of sunscreen on hand. "Before I was a guard, I didn't really understand how much sun I was getting," Read said as he headed toward another shift in the guard's chair. It took only his first day on the job for him to realize, he said, "Geez, I'm a little burnt."
He even went one step further, getting contact lenses with extra UV protection. Through the lenses and his sunglasses, he looked out at all the skin pinking, browning and reddening up, and he shook his head.