Referring clinicians for the dermatopathology data comprised more than 95% dermatologists in private practice, with few samples from dermatologists in academic or surgical settings. The HIRD sample is representative of commercially insured populations.The predictive value of any test depends on both diagnostic accuracy and disease prevalence, and the latter is very low for melanomas before age 18 years. The very high NNB is also likely attributable to reliance on "change" as an important criterion for recognizing melanoma. Evolution of nevi is common in childhood, and hence change is a poor predictor of melanoma in this age group. 6 Understanding the normal evolution of nevi during childhood and adolescence, as well as development of novel noninvasive diagnostic tools, is important in helping to reduce unnecessary biopsies, health care costs, and morbidity in this age group.

Purpose The purpose of this study is to describe the epidemiology of melanoma among Hispanics using data that cover nearly 100% of the United States (US) population. Methods The study used population-based cancer incidence data from the National Program of Cancer Registries and the Surveillance Epidemiology and End Results program to examine melanoma incidence rates and trends among Hispanics by sex, age, race, histology, anatomic location, stage, and tumor thickness. Results From 2008 to 2012, 6,623 cases of melanoma were diagnosed among Hispanics. Rates were higher among males (4.6) than females (4.0), but females younger than age 55 had higher rates than males. The most common histologic subtype was superficial spreading melanoma (23%). Melanomas with poorer outcomes, such as nodular (NM) and acral lentiginous melanoma (ALM), were more common among males. Hispanic females had the highest proportion of melanoma on the lower limb and hip (33.7%) while Hispanic males had the highest proportion on the trunk (29.9%). Incidence rates for later stage and thicker tumors were significantly higher among Hispanic men than women. Incidence rates decreased significantly during 2003–2012 (AAPC= −1.4). Conclusions Clinicians and public health practitioners will need to reach the growing Hispanic population in the US with strategies for primary prevention and early diagnosis of melanoma. Results suggest Hispanics and providers need education to increase awareness about the characteristics of melanoma among Hispanics, including types that occur on non-sun-exposed areas (ALM, NM). Skin cancer prevention and awareness interventions targeting Hispanics should be culturally relevant.

Surveillance of cervical intraepithelial neoplasia grade III (CIN III) and adenocarcinoma in situ (AIS) is important for determining the burden of a preventable disease, identifying effects of vaccination on future diagnoses, and developing targeted programs. We analyzed population-based rates of high-grade cervical cancer precursor lesions using data from four central cancer registries (diagnosis years 2009–2012 from Louisiana, Kentucky, Michigan, and diagnosis years 2011–2012 from Los Angeles) by age, race, and histology. We also compared rates of precursors to invasive cancers. With 4 complete years of data from Michigan, we were able to conduct a trend analysis for that state. Data analysis was conducted in Atlanta during 2016. Kentucky reported the highest rate of CIN III/AIS (69.8), followed by Michigan (55.4), Louisiana (42.3), and Los Angeles (19.2). CIN III/AIS rates declined among women in Michigan by 37% each year for women aged 15–19, 14% for those aged 20–24, and 7% for those aged 25–29. Rates of CIN III/AIS vary by registry, and were higher than invasive cancer. In Michigan, declines in CIN III/AIS among women aged 15–29 are likely related in part to updated screening recommendations, and to the impact of human papillomavirus vaccination.

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