6-Fold Melanoma Increase Is Found Among Young Adults

Cutaneous melanoma is becoming increasingly common in young adults, new data show.

Jerry D. Brewer, MD, assistant professor of dermatology at the Mayo Clinic in Rochester, Minnesota, and colleagues used data from the Rochester Epidemiology Project (REP) to identify patients 18 to 39 years of age who were first diagnosed with cutaneous melanoma between January 1, 1970, and December 31, 2009, in Olmsted County, Minnesota. The REP is a medical records linkage system that archives data on patient care provided to Olmsted County residents.

Little information is available about cutaneous melanoma in young adults, the investigators noted. Studies to date have been too small and populations have been poorly defined. Earlier research has also been limited by the underreporting and delayed reporting that typically occur with registry-based epidemiology studies.

Overall, 256 young adults were included in the analysis.

Results showed that the incidence of cutaneous melanoma increased more than 6-fold in the study population during the 40-year surveillance period, with an 8-fold increase among young adult females and a 4-fold increase among young adult males.

Investigators suggested that the increasing cancer incidence in young women may be a function of “some gender-specific behaviors that lead to different ultraviolet exposure.” Younger women are more apt to engage in activities that increase the risk of cutaneous melanoma than young men, including the use of sunlamps and tanning beds.

The overall age- and sex-adjusted incidence of cutaneous melanoma for the entire cohort was 16.9 per 100,000 person-years. The age-adjusted incidence was higher in females than males (23.2 vs 10.8 cases per 100,000 person-years; P = .001).

The data also showed that each one-year increase in calendar year of diagnosis was associated with a significantly decreased risk of death from any cause (hazard ratio [HR], 0.92; P = .005) and a significantly decreased risk of death due to metastatic melanoma (HR, 0.91; P = .01).

The location of cutaneous melanoma among young adults apparently differs between sexes. For females in this age group, the most common location of cutaneous melanoma was the lower extremity, followed by the upper extremity. In males, melanoma was most often found on the back, followed by the upper extremity.

The authors cited the homogenous demographic makeup of the study population as a possible limita- 6-Fold Melanoma Increase Is Found Among Young Adults tion. The population was largely white and highly educated, and the results may therefore not be universally applicable to young adults throughout the United States. It is also possible that some cases of melanoma among Olmsted County residents were not included because the patients were treated elsewhere.

Reed KB, Brewer JD, Lohse CM, et al. Increasing incidence of melanoma among young adults: an epidemiological study in Olmsted County, Minnesota. Mayo Clin Proc. 2012;87(4):328-334.