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Melanoma rates decline among US adolescents, young adults
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Incidence of invasive melanoma decreased among adolescents and young adults in the United States between 2006 and 2015, according to results of a population-based study published in JAMA Dermatology.
The decline occurred as rates of melanoma, the fifth most common cancer in the U.S., increased among Americans aged 40 years and older.
“We do not know why these trends are occurring; however, we hypothesize that public health campaigns and messaging aimed at promoting sun protection in childhood may be shaking out to have an impact on decreasing melanoma incidence in adolescents and young adults,” Jennifer M. Gardner, MD, assistant professor in the division of dermatology at University of Washington, told HemOnc Today. “I do not know if legislation aiming to ban indoor tanning access for minors has contributed to the trend that we’ve seen over the past decade, but I would [think] that legislation and enforcement of laws to keep minors out of tanning beds would over time impact the incidence of melanoma in these populations, as well.”
Despite public health initiatives launched in the 1990s and 2000s to increase sun-protective behavior — including use of broad-spectrum sun protection factor 30-plus sunscreen, ultraviolet protection factor 50-plus clothing, broad-brimmed hats and UV-protective sunglasses — overall incidence of melanoma has increased to more than 80,000 cases per year in the U.S., according to Gardner and colleagues.
However, declines in melanoma rates among adolescents and young adults may suggest that the sun-protection initiatives are having an impact.
Gardner and colleagues analyzed data from the combined National Program of Cancer Registries-SEER database to determine the annual rates of melanoma between 2001 and 2015 among pediatric (aged 0-9 years), adolescent (aged 10-19 years) and young adult (aged 20-29 years) age groups, as well as adult age groups in 10-year increments from age 30 years to age 80 years or older.
Among 988,103 invasive melanoma cases diagnosed between 2001 and 2015, 40,425 (4.1%) occurred among patients aged younger than 30 years. The number of cases overall increased steadily during the period, from 50,272 in 2001 to 83,362 in 2015.
Researchers stratified their data analyses by sex- and age-adjusted incidence rates to the standard 2000 U.S. population. They used the weighted least squares method to calculate the annual percentage change (APC) in incidence rate from 2006 to 2015, the most recent decade for which they could obtain data.
Results showed that the overall melanoma incidence rate increased between 2006 and 2015, from 200.1 to 229.1 cases per million person-years.
Melanoma rates increased by an APC of 1.8% among both men (95% CI, 1.4-2.1) and women (95% CI, 1.4-2.2) aged 40 years and older.
However, researchers observed declines in rates among the younger population, including an APC of 4.4% (95% CI, 1.7 to 7) for male adolescents, 5.4% (95% CI, 3.3 to 7.4) for female adolescents, 3.7% (95% CI, 2.5 to 4.8) for male young adults and 3.6% (95% CI, 2.8 to 4.5) for female young adults (P < .001 for all). Incidence rates appeared “low and stable” among male and female children, according to the researchers.
Risk for melanoma appeared twice as high for young adult women than young adult men.
A lack of information of skin pigmentation, UV light exposure, sunburn history, sun-protective behavior, protective clothing, sun avoidance and tanning bed use served as the study’s primary limitation.
“We hope that we will continue to see a durable trend in lowered melanoma incidence for younger individuals, and it will be interesting to see if the current adolescent and young adult groups continue to have a lower incidence of melanoma over time,” Gardner said. “We hope this study lends support to continue and even improve prevention efforts going forward.” – by John DeRosier
For more information:
Jennifer M. Gardner, MD, can be reached at jen1110@uw.edu.
Disclosures: Gardner reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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