Why redheads like Fergie are at greater risk of skin cancer

SARAH FERGUSON has been diagnosed with malignant melanoma at the age of 64, and is understandably finding it ‘distressing’ so soon after her breast cancer diagnosis. There is a small chance that the two might be linked as the faulty BRCA2 gene that raises the risk of breast cancer is also possibly associated with melanoma. But it is not very likely, and we obviously don’t know if she carries this gene.

It is far more likely that her diagnosis is linked to her age and the fact she has fair skin and red hair. Red-haired people are, for several reasons, at an increased risk for developing skin cancer.

Redheads have a different balance of melanin, or pigment, in their skin. This pigment acts as a filter against UV rays, which are emitted from the sun or sunbeds and can damage DNA in skin cells and start the cancer process.

There are two types of melanin: pheomelanin and eumelanin. We all have a mix of both, but redheads tend to have more pheomelanin, which is less protective against UV rays.

Studies have shown that redheads also carry variants in melanocortin-1 receptor (MC1R) gene, which controls production of skin pigment and is responsible for redheads’ distinctive hair and skin colour.

But this also means they’re more likely to develop skin cancer — of all types, including the most dangerous form, melanoma. Apart from its role in pigmentation, the MC1R variant found in redheads is also associated with undermining important defence mechanisms against UV, meaning their bodies may be less effective at repairing damage. Some people with other hair colours, such as auburn and blonde, can carry one version of the MC1R variant gene, which makes them more vulnerable to all types of skin cancer, although they may not realise their greater risk. Her age also puts Sarah Ferguson at a higher risk of melanoma. Plus, she belongs to an age group who were often exposed to high levels of UV rays in childhood and early adulthood, partly as travel overseas really took off. A patient’s prognosis depends on the stage of the cancer and how far it has spread. The five-year survival rate for patients whose melanoma is contained in the top layer of the skin is around 97 per cent, compared with 10 per cent if it has spread around the body. Luckily, we now have drugs including ipilimumab, nivolumab and pembrolizumab, which have changed the landscape for patients with later stage melanoma.