Melanoma Molecular Maps Projects

Padova

Epidemiology

The incidence of melanoma is rising faster than any other malignancy [1-9]. Despite this evidence, the mortality rates for melanoma are not increasing at the same pace. This presumably occurs because patients present at an earlier stage of tumor development and there has been a significant increase in screening for melanoma with a large number of very borderline and very thin melanomas now representing a large proportion of the excess of tumors seen in the last 20 years.

In the USA the incidence of melanoma is 60,000 new cases per year (about 4% of all newly diagnosed cancers), which makes melanoma the fifth most frequently diagnosed malignant tumor (Figure 1). Approximately 1 out of 80-90 Americans alive today will develop melanoma in their lifetime, with a mortality of 8,000 people per year.

In Europe, cutaneous melanoma represents 1-2% of all malignant tumors. Overall, 18,000 new diagnoses and 5,000 deaths from melanoma are registered in Europe every year.

The incidence of melanoma shows a typical geographical variability. Individuals with Celtic ancestry appear to have the highest predisposition to develop this type of cancer. As Celtic people migrate to more temperate regions, the incidence of melanoma increases: this is particularly evident in Australia, where the highest incidence of melanoma can be found among whites (approximately 35 cases/100,000 inhabitants per year, the highest incidence of melanoma in the world). However this difference in the incidence of melanoma in Australia can also in part be explained by a very aggressive screening for melanoma with an excess of melanoma in situ and very thin melanomas which is less apparent in Europe where the screening programme are not as active.

Melanoma is rare in non-whites (Caucasians : Asian/Black populations = 20 : 1) and mostly confined to non pigmented sites such as the subungual regions, the palms of the hand and the soles of the feet. However, the mortality rate is higher in non-white patients.

There is a slight female preponderance (54%) although in Europe this slight female preponderance no longer exists, while the mortality rates are slightly higher in men compared to women even adjusting for tumor thickness. There appears to be therefore t be some unknown gender related factors which improves survival which are yet unknown. The average age of a person with melanoma is 50 years, which is a relatively young age for a cancer patient. Melanoma is extremely rare prior to puberty; thereafter the incidence increases with age until the 5th decade.

The distribution of skin melanoma in the different body areas is not homogeneous and differs in males and females, as shown in the below Figure 2, where gender-related factors again appear to be important for this tumor. Furthermore this is also reflected in the distribution of nevi on the body with more nevi on the limbs in females whilst males have more nevi on the trunk which reflects the body site distribution of melanoma in males and females.


References

[1] Jemal A et al, Cancer Statistics 2006. CA Cancer J Clin 2006, 56: 106-30

[2] Thompson JF et al, Cutaneous melanoma. Lancet 2005, 365: 687-701

[3] Balch CM et al (Eds.), Cutaneous melanoma. Quality Medical Publishing 2003 (4th edition)

[4] Beddingfield FC, The melanoma epidemic: res ipsa loquitur. Oncologist 2003;8: 459-65

[5] Desmond RA et al, Epidemiology of malignant melanoma. Surg Clin North Am 2003, 83: 1-29

[6] Markovic SN et al, Malignant melanoma in the 21st century, part 1: epidemiology, risk factors, screening, prevention, and diagnosis. Mayo Clin Proc 2007, 82:364-80

[7] Demierre MF. Epidemiology and prevention of cutaneous melanoma. Curr Treat Options Oncol 2006, 7:181-6

[8] Berwick M et al, The current epidemiology of cutaneous malignant melanoma. Front Biosci 2006, 11:1244-54

[9] Bataille V et al, Melanoma--Part 1: epidemiology, risk factors, and prevention. BMJ 2008, 337:a2249



AUTHOR(s)

Veronique Bataille (West Hertfordshire Hospitals NHS Trust, Hemel Hempstead HP2 4AD, bataille@doctors.org.uk)


UPDATED

May 2009



Figure 1: Annual incidence of new cases (and relative frequency) of malignant tumors in the United States [1].




Figure 2: Site distribution of cutaneous melanoma according to sex.

Search the site


Risk Assessment Tools

TNM Staging System | Total Dermoscopy Score | Thin Melanoma Prognosis |


Melanoma News


NCBI's Disclaimer and Copyright notice