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Mortality rate greater among young white males than females with melanoma

White male adolescents and young adults with melanoma had worse survival rates than females of the same age groups despite having lower disease incidence in a study published today.

Researchers studied a population-based cohort of 26,107 non-Hispanic white adolescents and young adults (10,378 males), aged 15 to 39 years at diagnosis of primary invasive melanoma, in the United States. The cohort (mean age at diagnosis, 31.9 years, males; 31.2 years, females) was assembled from cancer registries for patients diagnosed between 1989 and 2009. Mean follow-up was 7.5 years, with melanoma-specific survival the main outcome and measure.

The cohort had 1,561 melanoma-specific deaths, with adolescent and young adult males comprising 63.6% of the deaths, although they accounted for 39.8% of melanoma cases.

After adjusting for tumor thickness, histological subtype, presence and extent of metastasis and anatomical location, males were 55% more likely to die of melanoma compared with age-matched females (HR=1.55; 95% CI, 1.39-1.73). Within each assessed age range (15-24 years, 25-29 years, 30-34 years and 35-39 years), males were more likely to die (80%, 67%, 71%, 35%, respectively, for age groups). Males with thin melanomas (≤1 mm) had a 95% greater risk for death than age-matched females (HR=1.95; 95% CI, 1.57-2.42). Results were not significantly altered after adjusting for health insurance and socioeconomic status.

“Despite lower melanoma mortality rates in younger men and women compared with older individuals, the risk of death in young men is 55% higher than in young women,” the researchers concluded. “Continued public health efforts are necessary to raise awareness of the outcome of melanoma in young men. This alarming difference in outcome highlights the urgent need for both behavioral interventions to promote early detection strategies in young men and further investigation of the biological basis for the sex disparity in melanoma survival.”