Incidence of Childhood and Adolescent Melanoma in the United States: 1973–2009

Abstract

WHAT'S KNOWN ON THIS SUBJECT: The incidence of childhood and adolescent melanoma has been significantly increasing up to 2004. Risk factors (fair skin, light-colored hair/eyes, female gender, presence of nevi, family history, increased number of sunburns, and exposure to UV radiation) are associated with melanoma.WHAT THIS STUDY ADDS: This study describes incidence trends of melanoma diagnosed between the ages of 0 and 19 years and from 1973 through 2009 by gender, stage and age at diagnosis, primary site, and exposure to UV radiation. abstract OBJECTIVE: Childhood and adolescent melanoma is rare but has been increasing. To gain insight into possible reasons underlying this observation, we analyzed trends in melanoma incidence diagnosed between the ages of 0 and 19 years among US whites by gender, stage, age at diagnosis, and primary site. We also investigated incidence trends by UV-B exposure levels.METHODS: By using Surveillance, Epidemiology, and End Results (SEER) program data (1973-2009), we calculated age-adjusted incidence rates (IRs), annual percent changes, and 95% confidence intervals for each category of interest. Incidence trends were also evaluated by using joinpoint and local regression models. SEER registries were categorized with respect to low or high UV-B radiation exposure. RESULTS:From 1973 through 2009, 1230 children of white race were diagnosed with malignant melanoma. Overall, pediatric melanoma increased by an average of 2% per year (95% confidence interval, 1.4%-2.7%). Girls, 15-to 19-year-olds, and individuals with low UV-B exposure had significantly higher IRs than boys, younger children, and those living in SEER registries categorized as high UV-B. Over the study period, boys experienced increased IRs for melanoma on the face and trunk, and females on the lower limbs and hip. The only decreased incidence trend we observed was among 15-to 19-yearolds in the high UV-B exposure group from 1985 through 2009. Local regression curves indicated similar patterns.CONCLUSIONS: These results may help elucidate possible risk factors for adolescent melanoma, but additional individual-level studies will be necessary to determine the reasons for increasing incidence trends.

Pediatric Population Reference Value Distributions for Cancer Biomarkers and Covariate-Stratified Reference Intervals in the CALIPER Cohort

“…Second, disease incidence can change over time; thus, cancers that have, in the past, typically arisen in the adult population can begin to arise in the pediatric population. For example, the incidence of melanoma in the pediatric population has been steadily increasing since 1973 (6 ). Thus, tumor markers such as squamous cell carcinoma antigen (SCC) 4 may now play an important role in pediatric as well as adult cancers.…”

Atypical Presentation of Malignant Melanoma in a 16 Months Old Child

“…In a study from 2002, only 1.3% of new melanoma cases diagnosed in USA from 1973 to 1996 were younger than 20 years [3]. Though rare, the incidence of childhood melanoma has been rising 2-2.9% per year in USA from 1973-2001 and has been seen to double in Sweden from 1973-1992 [4,5,6]. Reported incidences in Australia and in the United States, are up to 30 and 14 per million respectively in adolescents.…”

“…Also sun exposure, multiple melanocytic nevi, dysplastic nevus syndrome and a family history of melanoma are risk factors. Furthermore in pediatric patients, xeroderma pigmentosum, giant congenital melanocytic nevus and immunosuppression are associated with an increased risk of malignant melanoma [1,5,7]. Risk factors specific for melanoma of infancy and early childhood have not been identified.…”

Erythemal ultraviolet solar radiation doses received by young skiers

“…Although sunburn is also a melanoma risk factor among adults 13,14 , the epidemiological evidence indicates that excessive exposure to sunlight at an early age is an important factor in determining the risk of skin cancer in the course of a lifetime [15][16][17][18][19] . Melanoma is rare in children, but several studies have documented an increase in their incidence in children and adolescents [19][20][21] . Childhood melanoma risk factors are less well understood than in adults.…”

“…Childhood melanoma risk factors are less well understood than in adults. Melanomas in younger individuals are thought to have a different pathology and have different risk factors, mainly genetic such as number of melanocytic nevi, family history of melanoma and immunosuppression, among others [20][21][22] . UV exposure is therefore the only known risk factor on which one can act to reduce the risk of skin cancer 18 .…”