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ROCHESTER — As warmer (albeit stormy) weather brings more Minnesotans outside, there's more focus on avoiding sunburns and preventing skin cancer down the road.

It turns out, Minnesotans have a higher rate of being diagnosed with melanoma compared to the United States as a whole. According to the from the National Cancer Institute and the Centers for Disease Control and Prevention, approximately Minnesotans are diagnosed with melanoma each year; the country's overall rate is 22.5 out of every 100,000 per year. Only Utah and Vermont have higher incidence rates than Minnesota.

First, what is melanoma? Dr. Jerry Brewer, a dermatologist at Mayo Clinic, said it is cancer that starts in melanocytes, the skin cells that create the colors in our skin. Like the rest of our skin cells, these melanocytes can be damaged by ultraviolet radiation, either from the sun or from tanning beds.

"When our melanocytes are exposed to the sun, there's some damage that happens to the DNA of those melanocytes, and our body has a very sophisticated way of targeting those damaged cells and correcting the damage," Brewer said.

Over time, though, Brewer said the body might not be able to keep up with getting rid of those damaged cells. If a damaged melanocyte isn't taken care of properly, it can replicate and start turning into cancer.

What's behind Minnesota's higher-than-average melanoma incidence rate? Are Minnesotans truly developing more melanomas, or are they just more likely to be diagnosed?

Brewer said one factor that could push Minnesota's rate higher is that some Minnesotans have Scandinavian ancestry.

"Fair-complected skin, blonde hair, blue eyes," Brewer said, "that sort of skin type — what we call skin — does have a little bit of a higher incidence of skin cancer, including melanoma."

Brewer also said that tanning bed use is a major risk factor for developing melanoma.

"Tanning beds are a crazy risk factor," Brewer said. "If you go even just once or twice at a young age, your chances can be 75% more likely."

However, Brewer said research has shown that the more dermatologists there are in a community, the in that area. With more dermatologists, particularly in Rochester, could melanoma simply be diagnosed more often due to that access to care?

"Perhaps," Brewer said, "but I tend to see that there's probably a pretty even distribution of dermatologists throughout the country. We do have a couple of major academic centers in Minnesota, and those have a pretty dense population of dermatologists — for example, in Rochester."

Beyond tanning beds and having a fair complexion, there are a few other factors that play into a person's risk of developing melanoma. Brewer said these include having more than five sunburns (or just one blistering sunburn) in your lifetime, having more than 50 to 100 moles on your body or living at a higher altitude, such as in Colorado, where the UV exposure is greater.

"If you're an airline pilot, the ultraviolet radiation that tends to be linked to melanoma is UVA, and UVA can go through cloud cover and it can go through windshields," Brewer said. "And if you're up higher, closer to the sun, that exposure can be a little more intense."

Since the risk of melanoma is strongly tied to UV exposure, Brewer said protecting the skin from UV radiation is key. This includes avoiding tanning beds, wearing hats and regularly using sunscreen.

"It's kind of like putting money in the bank account; the interest will start to accrue over the years, and the more years that go by with that habit in place, the more benefit," Brewer said of sunscreen. "Just using an SPF of 15 but doing it daily reduces your chances of melanoma by 50%."

More often than not, melanoma appears as a new spot on the skin rather than an existing mole.

"Seventy to 80% of melanomas are brand new dark spots," Brewer said. "Only about 20% to 30% are from a mole that has already been there and just decides to turn bad."

What to watch for, Brewer said, is evolution — has the spot changed shape, size, color or in any other way?

"Some people tell me it starts to itch, or maybe it bleeds a little bit, but it's so early that it looks pretty normal," Brewer said. "There's been a number of times where we'll just check it and it's an early melanoma."

Other things to notice, Brewer said, are asymmetry, irregular borders, multiple colors in one mole or spot and diameter larger than a pencil eraser. These, along with evolution, make up the per the American Academy of Dermatology.

Brewer said catching changes early can help increase one's odds of surviving melanoma. Just are melanoma, but melanomas cause the biggest share of skin cancer deaths.

"Just the simple act of looking your skin over can probably increase your chances of finding a melanoma early, which the key to surviving melanoma is catching it early," Brewer said. "Taking the time once a month, whatever is your favorite day of the month, taking a good look at your skin and keeping an eye on anything that's changing or new."