All you California girls pay attention: Melanoma, the most serious form of skin cancer, occurs about 20 times more often in people with fair complexions than it does in people with darker skin. But, when it is found in people with darker skin, they often fare worse than blond-haired, blue-eyed folks. Some scientists have speculated that melanoma may act differently in nonwhite people. Researchers at the University of Hawaii compared cases of skin cancer to see whether the disease progressed differently based on ethnicity.

What the researchers wanted to know: Does melanoma act differently and become more dangerous in people with darker skin?

What they did: The researchers, some of whom were medical doctors, saw 357 skin cancer patients from January 1994 to August 2003. They kept track of where on the body the skin cancer was found, how big it was, and the chance of recovery for each patient. They also asked patients about their ethnicity, and classified them as either white or nonwhite.

What they found: Overall, 19 percent of the patients treated for melanoma were nonwhite. White patients were more likely to have the cancer on their neck, trunk, extremities, and on the skin of their head. In addition to having melanoma in more unusual places (like under the nails), nonwhite patients also were diagnosed in much more advanced stages of cancer, and so the chance of their recovery was not as good as in white patients. However, when whites and nonwhites were diagnosed at the same stage, the chance of recovery was equal.

What it means to you: The authors don't know why nonwhite people develop melanoma in different places than whites but say that could be a sign that it is actually a different type of cancer. However, they say that nonwhites are more likely to die from melanoma, probably because, in those people, it is often not diagnosed until the cancer is at an advanced stage. Early detection, according to the authors, is one of the most important ways to fight skin cancer.

Caveats: The doctors in this study speculated that whites and nonwhites might have a different kind of melanoma, but they only looked at external factors such as the location of the tumor and its size. To answer whether the cancer was fundamentally different, they would need to examine the cancer cells under a microscope and see if they looked or acted differently in people from different ethnicities.

Find out more: The National Institutes of Health has a good, detailed explanation of who is at risk for skin cancer and how it can be prevented.

The nonprofit Skin Cancer Foundation also has an enormous amount of information.

Read the article: Hemmings, D.E. et al. "Cutaneous Melanoma in a Multiethnic Population: Is This a Different Disease?" Archives of Surgery. September 2004, Vol. 139, No. 9, pp. 968–973.

Abstract online: http://archsurg.ama-assn.org