Cutaneous cancers in the Africans: Systematic review

Abstract Introduction Skin cancers are uncommon in Africans and dark‐skinned people but when diagnosed they often have a poor prognosis. Darker skin has increased photoprotection against the high‐intensity ultraviolet radiation (UVR) of the tropics and the subtropics due to high eumelanin content. While UVR has been found to play a significant role in the pathogenesis of cutaneous malignancies in Caucasians, it is of less significance in Africans. Aim This study aims to highlight the burden of cutaneous cancers in Africans, the predisposing factors, clinical features, and management challenges. Methodology This is a systematic review of literature on skin cancers in Africans. The search included PubMed, African Journal online, Medline, and Google scholar on articles published between January 1968 and December 2017 (a 50‐year period). Reports from institutions, pathology departments, skin clinics, cancer registries, and databases were reviewed. Articles were excluded if they do not specify types of skin cancers and frequencies of occurrence. Result Squamous cell carcinoma (SCC) was the most documented skin cancer in Sub‐Saharan African countries with darker skin color; and BCC in North African countries with lighter skin color. The highest frequency of cutaneous melanoma was documented in Tanzania. Cancer registries in Uganda and Zimbabwe reported very high prevalence of KS. Albinism is the most common genetic predisposition for cutaneous cancers in Africans. There has been a general increase in the prevalence of skin cancers with the advent of human immunodeficiency virus infection. Africans with albinism present mostly with aggressive, invasive, and multiple SCC. Pigmented BCC and acral lentiginous melanoma were mostly documented in the dark skinned Africans. Management is mostly hindered by high cost and poor infrastructures. Conclusion Squamous cell carcinoma, BCC, and cutaneous melanoma were the most documented skin cancers. Oculocutaneous albinism, immune suppression (HIV), and oncogenic viruses were important risk factors for skin cancers in Africans. Public health strategies such as skin cancer screening programs for susceptible groups; training of health care workers and infrastructure development will help reduce severity.