Skin cancer, including common forms like basal cell and squamous cell carcinoma, and the more aggressive melanoma, represents a significant public health issue across the United States. Damage to skin cells from ultraviolet (UV) radiation is the primary cause, making geographic location a substantial factor in determining risk. The intensity of sunlight, duration of exposure, and prevalence of outdoor activity vary widely by region, directly influencing state-by-state incidence rates.
Identifying the Highest Risk Areas
The state that consistently reports the highest incidence rate for melanoma is Utah, according to data from the Centers for Disease Prevention and Control (CDC). Utah has reported rates exceeding 44 cases per 100,000 people, significantly higher than the national average. This places Utah at the top of a regional cluster of states, primarily in the Mountain West. Other states with notably high melanoma rates include Minnesota, Vermont, and Idaho. This pattern defies the expectation that only states with warm, year-round sun exposure would be most affected, as these regions often have rates comparable to those in Sun Belt states like Arizona.
Geographic and Environmental Drivers
The high rates in states like Utah and Colorado are partly explained by altitude. For every 1,000 feet increase in elevation, UV radiation exposure intensifies by approximately 4% to 5%. Utah’s high elevation means residents are exposed to less filtered UV radiation. Furthermore, the reflection of UV rays off surfaces significantly amplifies exposure, even in cooler climates. Snow is a powerful reflector, capable of doubling the amount of UV radiation that reaches the skin, which combines with year-round outdoor recreation to cause greater cumulative UV damage.
Demographic and Behavioral Factors
A major factor influencing the high rates in states like Utah and Vermont is the demographic composition of the population. Melanoma incidence is substantially higher in non-Hispanic white populations, particularly those with lighter skin types, fair hair, and light-colored eyes, who are more susceptible to UV damage. These characteristics are common in high-incidence states, increasing the baseline risk. Many residents have ancestors from northern European countries, inheriting skin types poorly adapted to higher UV loads. Behavioral habits specific to these regions further elevate the risk, including high participation in recreational outdoor activities and a history of indoor tanning.
Practical Risk Reduction Strategies
Reducing the risk of skin cancer relies on adopting consistent sun-safe behaviors.
Seeking Shade and Protective Clothing
A primary strategy involves seeking shade, particularly during the peak sun hours between 10 a.m. and 4 p.m., when UV rays are strongest. Protective clothing provides a physical barrier against UV radiation. This includes wearing long-sleeved shirts, pants, and a wide-brimmed hat that shades the face, neck, and ears. Clothing with an Ultraviolet Protection Factor (UPF) rating offers enhanced protection.
Sunscreen and Detection
Applying a broad-spectrum sunscreen with an SPF of 30 or higher is a foundational step. Sunscreen should be applied generously to all exposed skin and reapplied at least every two hours, or immediately after swimming or sweating. Beyond daily protection, regular skin self-exams and professional screenings are important for early detection, which significantly improves the prognosis for melanoma.