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Men, Melanoma, and Mortality

Summary and Comment |
January 10, 2014

Men, Melanoma, and Mortality

  1. Hensin Tsao, MD, PhD

Since 1950, melanoma incidence has increased more than 20-fold in older men, and the rate of associated mortality in men has tripled.

  1. Hensin Tsao, MD, PhD

The Connecticut Tumor Registry, the longest-operating population-based cancer registry in the U.S., has been a vital source of cancer information for the past 60 years. A recent trend analysis revealed an emerging vulnerability for melanoma among men.

The reviewers examined trends from 1950 to 2007 in the incidence of invasive melanoma and in situ melanoma, mortality, and the mortality-incidence ratio among 19,973 Connecticut residents diagnosed with invasive melanoma and 3635 with melanoma-related deaths. A diagnosis of invasive melanoma was rare from 1950 to 1954: 1.9 per 100,000 in men and 2.6 per 100,000 in women. By 2007, overall incidence rates had risen more than 17-fold in men (to 33.5 per 100,000) and more than 9-fold in women (to 25.3 per 100,000). In men older than 50, rates increased more than 20-fold, with a 45-fold increase in men aged 65 to 69. From 1950 to 2007, the rate of melanoma-related mortality tripled in men and doubled in women.

Comment

The most compelling findings in this study are the greater than 20-fold increase in melanoma incidence and the tripling of related mortality in men. In men older than 70, 1 death occurs for every 5 melanoma cases versus 1 death per 14 melanoma cases in men aged 45 to 49. Trends to higher rates were also noted among women, but not to the same extent, which resonates with my personal clinical experience. Even though thick melanomas are less common these days, bulky melanomas seem to occur most often on the sun-damaged head and neck areas of older men.

  • Disclosures for Hensin Tsao, MD, PhD at time of publication Consultant / advisory board Genentech; Quest Diagnostics; WorldCare Clinical Grant / research support NIH; Department of Defense; American Skin Association Editorial boards British Journal of Dermatology; Journal of the American Academy of Dermatology; Journal of Investigative Dermatology Leadership positions in professional societies American Academy of Dermatology (Chair, Skin Cancer and Melanoma Committee); American Board of Dermatology (Director)

Citation(s):

Reader Comments (3)

Ulrich Pfeffer PhD Other Healthcare Professional, Oncology, IRCCS AOU San Martino - IST

20 fold incidence, triple mortality: It remains to be seen how much of this is overdiagnosis and how much is prevention of aggressively growing cancer through early detection.

Alejandro Morales Physician, Dermatology, Lima Perú

We routinely advise patients to have the neck and back check by partner every 2 months. Specially in patients older than 40 years of age.

ROBERT KAUFMANN Physician, Pediatric Subspecialty, Home office

Your survey "disappeared." In my experience viscous lidocaine has been very useful in some case. The melanoma abstract is extremely useful.

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