Melanoma: The Increasing Trends You Shouldn’t Ignore
Written By: Kenneth R. Warrick, MD, FAAD
As one of the senior dermatologists in South Carolina, over the past third of a century I have witnessed some striking changes in malignant melanoma. With in this time frame, the number of new melanoma cases per 100,000 persons living in the United States has increased from 7.9 to 23.6, a three-fold increase. We have attributed this to increased recreational sun exposure and wearing of clothing that bares more skin to the sun. Ozone layer thinning and global warming would add to this. According to statistics cited by the American Academy of Dermatology, by 2015, it is estimated that one in 50 Americans will develop melanoma in their lifetime. The highest percentage of new cases are discovered between the ages of 55 and 64. Overall, more men develop melanoma than women, and an even higher percentage of men die of their melanoma.
During my career to date, melanoma has shockingly become the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for adolescents and young adults 15-29 years old. Melanoma is increasing faster in females 15-29 years old than males in the same age group. Melanoma in Caucasian women under the age of 44 has increased 6.1 percent annually, which may reflect recent trends in indoor tanning and tanning bed usage.
The World Health Organization estimates that more than 65,000 people a year worldwide die from melanoma. On average, one American dies from melanoma every hour. For 2013, it was estimated that 9,480 deaths would be attributed to melanoma — 6,280 men and 3,200 women. The greatest percentage of melanoma deaths occur after age 55. Since I started my dermatology practice in 1975, U.S. deaths due to melanoma increased from 2.1 to 2.7 per 100,000 population, a 28.6% increase. The improved ratio of new cases to deaths reflects earlier diagnosis. It is still true that the best survival (98% 5-year survival) results from early detection, excising the lesion before it has metastasized. While 5-year survival of all melanoma patients (regardless of stage) as a group has increased from 81.9% to 93.1%, this may be more a measure of earlier diagnosis and the improved life expectancy of the population at large rather than being due to improved melanoma treatment success.
Surgery still remains the mainstay of treatment, though a few new drugs have helped patients with metastatic disease. Until a cure is found, the most effective treatment must be prevention. Dermatologists have taken a very proactive role in educating our patients and the population at large about the dangers of sun exposure, tanning bed usage, and proper use of sunscreens and other methods of sun avoidance. Members of the American Academy of Dermatology have developed programs to encourage schools to build sun shelters for students during playground activities. The overall effectiveness of these measures depends upon the application of these principles in changing personal and public policies and habits. Just as with the old safe driving adage, “The life you save may be your own.”
*Know the warning signs of melanoma by learning your ABCDs. If you have a suspicious mole or one which has changed in any way, please contact a board-certified dermatologist to have it examined.