1. The incidence of melanoma in children and adolescents increased at an annual rate of 2.0% per year from 1973-2009.
2. Ultraviolet-B (UV-B) exposure was not considered the primary contributing factor in the rise in melanoma cases as melanoma incidence rates increased significantly in low UV-B exposure areas in the country and stayed relatively constant in high UV-B exposure areas.
Evidence Rating Level: 2 (Good)
Study Rundown: Melanoma is the most commonly diagnosed skin cancer in the pediatric population. Much is known about risk factors for adult melanoma, and, while research on childhood melanoma is sparse, it has implied differences in etiology and behavior among younger individuals. In this study, researchers focused on defining incidence rates (IRs), comparing melanoma site location, and indentifying gender differences while taking UV-B exposure into account among children 0-19 years of age. Researchers found that melanoma IRs steadily increased among 10-19 year olds, but remained stable in those 0-9 years of age. UV-B exposure was not a major contributor in the increase in IR as melanoma cases in high UV-B exposure areas remained stable, but low UV-B exposure areas increased significantly over the years studied. This study’s findings may have been influenced by researchers’ inability to account for individual participant UV exposure (sun light, tanning beds, etc…), familial factors, and changes in diagnosis patterns. While this study highlights increasing melanoma IR, more research is needed to define risk factors for adolescent melanoma so that effective preventative measures may be designed.
Relevant Reading: Trends in childhood cancer incidence in the U.S. (1992-2004).
In-Depth [retrospective cohort]: This study described melanoma IR in children and adolescents ages 0-19 years old in the US. Researchers gathered melanoma diagnosis data from 1973-2009 using the Surveillance, Epidemiology, and End Results (SEER) database. 1230 Caucasian children diagnosed with melanoma were included. Cases were separated into low and high UV-B exposure groups based on geographic location. Melanoma IR increased in both males and females, with females having a significantly higher IR (7.4 vs. 4.6; 95% CI). In high UV-B exposure areas, the IR was slightly greater than in low UV-B exposure areas; however, the annual percent change in low exposure areas was significantly higher, increasing by 3.7% per year when compared to high exposure areas where annual percent change stayed fairly constant. Melanoma sites differed significantly by gender with males having increased melanomas on parts of the face (5.2% per year; 95% CI, 1.3-9.2) and trunk (2.6% per year; 95% CI, 0.9-4.4) compared to females who experienced more melanoma on lower limbs and hips (3.2% per year; 95% CI, 1.8-4.7).
By Brandon Childs and Leah H. Carr
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