Pediatric Melanoma on the Rise

Rates of melanoma in children have increased 2% per year since the 1970s, with girls, those aged 15 to 19, and those living in areas with high UV-B exposure at greatest risk.

Melanoma is the most common skin cancer in children and adolescents in the United States, and data included in a study published in the May 2013 issue of Pediatrics indicate its incidence has increased at an average of 2% per year in pediatric populations over the last 4 decades.

In the study, a group of pediatric cancer researchers used the Surveillance, Epidemiology, and End Results (SEER) database to describe trends in childhood and adolescent melanoma incidence. They examined patient gender, melanoma stage, age of patient at diagnosis, and primary site of melanoma for the period 1973 through 2009 in 1230 white subjects. (As there were only 77 cases of melanoma in patients of all other ethnicities, they were excluded from the analysis.) The researchers also looked at associations between melanoma diagnosis and ultraviolet B (UV-B) exposure levels. (Average annual UV-B flux was collected from various geographic locations and varied by latitude, altitude, and sky cover; lower UV-B exposure is generally found in northern geographic locations.)

“Whereas melanomas in older children and adolescents (≥10 years) behave similarly to adult melanomas, those in younger individuals are thought to have a different etiology,” Jeannette R. Wong, MPH, of the radiation epidemiology branch of the Division of Cancer Epidemiology and Genetics of the National Cancer Institute, and colleagues wrote. “Unlike adults, more girls are affected than boys, and whites are at a higher risk than other racial groups.”

The researchers determined that girls, those aged 15 to 19 years, and those living in areas with high UV-B exposure exhibited significantly higher incidence rates of melanoma than boys, younger children, and those living in areas with low UV-B exposure, respectively. Sun exposure is a serious contributing concern because most of an individual’s total lifetime UV exposure occurs during childhood. The researchers believe that UV-B exposure is not the leading cause of increased melanoma incidence, but all of the trends of most concern occurred on areas of the body regularly exposed to the sun.

Overall trends were similar for both genders. Boys, however, were at greater risk of lesions on the skin of the face and trunk. For girls, the lower limbs and hips were of greater concern.

Although melanoma incidence has increased since the 1970s, malignant melanoma survival rates have increased over the same period. “Five-year survival is currently nearly 100% for cases diagnosed in localized stages versus 82% for cases diagnosed in regional or distant stages,” the researchers wrote. “These data emphasize the importance of early detection.”

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.

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