ADAMSON: Death from any cancer is all - all of it's terrible. All of it's bad. I'm not saying, let people just die, OK? But if you're thinking about the problems, the things to think about as a Black person that you could potentially die from or that is dangerous, skin cancer is the bottom of the list.
PARADIS: Black people do get melanoma, and when they do, it's proportionally deadlier. But usually it occurs in places typically not exposed to the sun, like the palms of the hand or the soles of the feet. Famously, Bob Marley died from a melanoma under his toenail. So UV radiation may not be a major risk factor for melanoma in skin of color.
ADAMSON: So for folks with skin of color, there's actually no data to support the use of sunscreen for cancer prevention, right? That just hasn't been shown.
PARADIS: Both epidemiologist David Whiteman and Adele Green, the investigator behind the Nambour Trial - they agreed. The results of the Nambour Trial can't necessarily be extrapolated to people of color. Not only that, but there is what David called very good data about the protective effects of melanin.
Like, he pointed to this study out of England where researchers simulated solar radiation on a variety of skin types to measure how melanin protected against DNA damage in the skin. And in this study, they found that compared to fair, European-origin skin types, the melanin content of the darkest skin tone demonstrated 60 times the protection against DNA damage in one of the deeper layers of skin.
WHITEMAN: And the melanin pigment just absorbs - it's like a shield of armor above the DNA - absorbs that ultraviolet radiation. And so there's almost no DNA damage when you give skin of color quite high levels of UV certainly that would - in a European-ancestry person would cause unbelievable DNA damage.
PARADIS: So back to that public health advice offered by major groups like the CDC, the American Cancer Society, the American Academy of Dermatology. They all say some version of, everyone needs to wear sunscreen every day. And that message?
ADAMSON: I think it is deeply flawed. But I understand why certain authorities and officials like to just give blanket recommendations - because it's easier.
PARADIS: Now, Ade's opinion is that blanket recommendations are not supported by evidence and that perhaps public health authorities should offer different, specific advice for people of color. And that's actually happening now in Australia.
RASCOE: Really? I mean, what are they doing there?
PARADIS: So Australia has one of the highest rates of skin cancer in the world. And now many public health authorities have endorsed new messaging, which does include different advice for different skin types. Epidemiologist David Whiteman has been part of crafting that messaging, and it hasn't been easy.
