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WASHINGTON (AP) -- The White House on Tuesday defended Laura Bush's decision not to disclose she had a skin cancer tumor removed from her right shin in early November.

Unlike her husband, the first lady is not an elected official, presidential spokesman Tony Snow said. "Perhaps if there's something more major, this would be discussed," he said.

The cancer was a squamous cell carcinoma, the second most common form of skin cancer, said Susan Whitson, her press secretary. She said the troublesome patch was about the size of a nickel.

Mrs. Bush, 60, decided the cancer was a private matter and did not reveal it publicly. On Monday night, the White House acknowledged the first lady had the tumor removed after Mrs. Bush was noticed with a bandage below her right knee.

Whitson said the first lady was still wearing a bandage more than five weeks after the incision because the skin on that part of the leg is thin and "it takes a little while to heal." Asked if plastic surgery might be required, Whitson said, "No further procedures are needed at this point."

A squamous cell carcinoma is a tumor that affects the middle layer of the skin. It is more aggressive than basal cell cancer, the most common form of skin cancer. Squamous cell cancer is more likely than basal cell cancer to spread to other locations, so patients need to have lymph nodes in the region near the tumor routinely examined, according to the National Cancer Institute's Web site.

More than 1 million cases of basal and squamous cell skin cancers are diagnosed annually, according to the American Cancer Society, which says that most but not all of these forms of skin cancer are highly curable.

Laura Bush's skin cancer came with a classic symptom, a slow-healing sore.

That made it hard to ignore, a good thing: Remove skin cancer early, and it's easy to cure.

Better is preventing skin cancer, and key is protecting yourself -- and your children, starting when they're tots -- from the sun. Sunburns early in life are considered the most dangerous.

Too few heed that advice. Skin cancer strikes over 1 million Americans annually, and is on the rise.

The toll probably won't drop "until this generation that started using sunscreen in childhood grows up," predicts Dr. Clifford Perlis, a dermatologist at Fox Chase Cancer Center in Philadelphia.

Between 1 million and 1.2 million Americans are diagnosed each year with basal or squamous cell carcinoma, the most common and easy-to-treat skin cancers, according to the American Cancer Society. Thousands more will have doctors remove sun-induced precancerous lesions called actinic keratoses.

Melanoma is the most lethal skin cancer, and strikes about 62,000 Americans a year. Of the estimated 10,700 skin-cancer deaths annually, almost 8,000 are due to melanoma. Yet if caught early, before it has spread, even melanoma is survivable.

Most at risk for all skin cancers are people with fair skin, difficulty tanning, or a history of excessive sun exposure. For melanoma, major risk factors include a relative with the disease and having lots of moles.

Specialists urge all adults to examine their skin regularly for suspicious changes, such as a new growth or change in an old one. What to watch for?

--Flat, firm, pale areas or small, raised, pink or red, translucent or shiny areas may signal basal cell carcinoma

--Squamous cell cancer may look like a rough reddish patch.

--A sore that doesn't heal can signal either type.

--Melanomas often arise as changes in moles. Any of the so-called "ABCD" warnings warrant a doctor check: Asymmetry, where half of the mole doesn't match the other half; Border irregularity, a ragged edge; Color, with different shades of brown, black, even red or blue; or Diameter, a mole bigger than a pencil eraser.

Key prevention advice: Avoid the most intense sun, between 10 a.m. and 4 p.m. Cover up, with a hat, sunglasses and protective clothing. A white T-shirt is the equivalent of sunscreen with an SPF of just 6, Perlis cautions. Darker colors and tighter weaves block ultraviolet rays better.

And use sunscreen daily, not just at the beach. Choose a "broad-spectrum" sunscreen, that guards against both ultraviolet-A and B rays.

"Just walking to and from the car, you're exposed to the sun," notes Perlis.

(Copyright 2006 by The Associated Press.  All Rights Reserved.)