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Good News, Bad News About Melanoma

Nick Mulcahy
February 02, 2018

There's good news, bad news about melanoma incidence in the United States among white American adults, according to a new analysis of the latest national statistics, which are for 2005 to 2014.

On the positive side, the rates over the 10-year study period decreased significantly among younger white adults (men age < 45 years and women age < 35 years). On the downside of the data, the rates increased significantly among older adults (men age > 54 years and women age > 44 years).

The new study, which is the first to concentrate on age groups, was published online as a research letter January 31 in JAMA Dermatology.

The decrease in incidence among young people is good news and was to be expected because a decrease has already seen in two factors that contribute to the disease, the investigators comment.

Use of indoor tanning, which exposes users to "intense levels of UV [ultraviolet] radiation," and the prevalence of sunburn, a "biological indicator of overexposure to UV radiation" have both decreased in recent years, particularly among adolescents and young adults, write the authors, led by Dawn Holman, MPH, from the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.

As a result of these two trends, which have been documented in earlier national surveillance data, a drop in melanoma incidence rates was expected over time, they explain.

Increase in Older Adults

Unfortunately, older white Americans are another story, with a "steady" uptick in incidence rates during the study period for all age groups.

In general, the older white Americans are, the greater the incidence rates because melanoma is a disease of aging. For example, among men, melanoma incidence rates ranged from 2.0 per 100,000 for 15- to 24-year-olds to 198.3 per 100,000 among those older than 85 years.

The investigators call "for efforts that promote skin cancer preventive behaviors throughout adulthood." They also suggest that public health efforts could focus on outdoor workers.

Such efforts would presumably primarily target white Americans; they have the highest incidence rates among all ethnic groups, the authors observe.

Study Details

In the new analysis, the CDC team calculated the average annual percentage change in melanoma incidence rates by 10-year age groups. The data came from CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results Program.

Table. Melanoma Incidence in White Americans (2005 to 2014)

Age (y) Average Rate per 100,000 Average Change (%) Statistically Significant
15 - 24 3.2 –5.1 Yes
25 - 34 12.1 –1.7 Yes
35 - 44 20.5 –0.5 Yes
45 - 54 32.4 0.4 No
55 - 64 50.4 1.3 Yes
65 - 74 82 2.5 Yes
75 - 84 109.9 3.6 Yes
85 107 4.6 Yes

The investigators also broke out their findings by sex. In general, the incidence rates over the 10-year study period were considerably higher for men than women.

The study was partially supported by the US Department of Energy. The authors have disclosed no relevant financial relationships.

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SOURCE: Medscape, February 02, 2018. JAMA Dermatol. Published online January 31, 2018.

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