Rising melanoma rates highest among young women

More young adults, particularly young women, are being diagnosed with cutaneous melanoma, but overall and disease-specific survival is improving, study data indicate.

Cutaneous melanoma incidence increased six-fold from 1970 to 1979 and 2000 to 2009 in Olmsted County, Minnesota, results of a longitudinal analysis using Rochester Epidemiology Project data show.

Despite these findings, the risk of dying as a result of melanoma decreased 9% a year over the same four decade time period, Kurtis B. Reed, MD, and colleagues from the Mayo Clinic in Rochester, Minn., reported in the Mayo Clinic Proceedings.

Although the largely white and highly educated study population may not be representative of the entire U.S. population, the study findings are congruous with national data from the CDC's Surveillance Epidemiology and End Results (SEER) database that show similar trends, the researchers noted.

"We anticipated we'd find rising rates, as other studies are suggesting," study researcher Jerry D. Brewer, MD, said in a press release. "But we found an even higher incidence than the National Cancer Institute had reported using the (SEER) database, and in particular, a dramatic rise in women in their 20s and 30s."

The analysis included 256 men and women, aged 18 to 39 years, who received their first lifetime melanoma diagnosis from Jan. 1, 1970, to Dec. 31, 2009. The incidence rate per 100,000 residents rose from 4.8 in 1970 to 1979 to 30.8 in 2000 to 2009, the researchers found.

From 1970 to 1979 there were 16 cutaneous melanoma diagnoses, compared with 44 in the 1980s, 67 in the 1990s, and 129 from 2000 to 2009.

Among men, melanoma incidence increased four-fold 4.3 per 100,000 residents to 18.6 during the study period. Rising melanoma rates were even higher among women, increasing from 5.4 to 43.5 cases per 100,000 residents for an overall eight-fold increase during the study period.

“This finding may be explained by some sex-specific behaviors that lead to different UV light exposure,” the researchers wrote, particularly indoor tanning, which has been identified as a significant melanoma risk factor.

Yet with each one-year increase in the calendar year of diagnosis, the researchers found an 8% reduction in the risk for death from any cause (P=0.005) and a 9% decreased risk for death from metastatic melanoma (P=0.01).

The increasing proportion of early-stage cancers diagnosed as the study years progressed suggest that skin cancer awareness may have improved over time, the researchers noted.

“Our results emphasize the importance of active interventions to decrease risk factors associated with melanoma in young individuals,” the researchers wrote. “In addition, skin cancer screening examinations in young adults are strongly recommended.”

Study participants had excellent access to medical care, the researchers noted, so the findings may not be generalizable to populations with more limited access.

Reed KB et al. Mayo Clin Proc. 2012;87(4):328-334.

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