Melanoma in children and adolescents

Paraben esters: review of recent studies of endocrine toxicity, absorption, esterase and human exposure, and discussion of potential human health risks

“…By contrast, melanoma has become a major public health problem in many countries and since the 1960s has risen by 3-8% per year in most European countries (Thompson et al, 2005) with an annual incidence rate in the UK in 2004 of 13.0 [age standardized rate (European) per 100 000 population], which is equivalent to 9000 new cases registered in 2004 in the UK (Gavin and Walsh, 2005). Melanoma affects younger people more than most cancers, with about 40% of cases in the under 50s (Gavin and Walsh, 2005), and there is currently a striking increase in incidence in youth (Strouse et al, 2005;Downard et al, 2007) and a strong inverse relationship with social deprivation (Gavin and Walsh, 2005). The natural history of human malignant melanoma has suggested that oestrogen might in½uence the incidence and development of these tumours (Schmidt et al, 2006), partly because the incidence in females is low before puberty, rising steeply through the reproductive years (Strouse et al, 2005), and survival may vary between men and women (Reintgen et al, 1984;Gavin and Walsh, 2005).…”

“…In the light of an involvement of ERβ on melanocytic pathophysiology (Schmidt et al, 2006), the ability of methylparaben to potentiate UV-induced damage in keratinocytes (Handa et al, 2006) and the ability of parabens to act via ERβ (Okubo et al, 2001;Gomez et al, 2005), a potential involvement of parabens (alone or together with other oestrogenic chemicals in cosmetics including UV ¼lters) should now be considered in studies of the development of malignant melanoma. The higher rate of melanoma in younger people (Gavin and Walsh, 2005;Strouse et al, 2005;Downard et al, 2007), the increasing incidence in youth (Strouse et al, 2005;Downard et al, 2007) and the inverse relationship with social deprivation (Gavin and Walsh, 2005) could all correlate with greater use of paraben-containing skincare/suncare products, be it through more lavish amounts at each application, more frequent applications or a lifestyle where products are required more often and at higher levels. It is interesting to note the recently reported left-sided excess of invasive cutaneous melanoma in six different countries (Brewster et al, 2007), which echos remarkably the similar ¼ndings of left-sided excess of breast cancers .…”

Prognostic factors for melanoma in children and adolescents

“…39,43,44 Some authors have concluded that it can be performed safely in the pediatric population. 18,41,[43][44][45][46][47][48][49] Given its low morbidity, SLNB also may serve as an adjunct procedure in the evaluation of diagnostically difficult tumors by increasing the sensitivity of the diagnosis and providing potentially useful prognostic information. 3,26,43,45,46,[49][50][51] In previous reports, SLNB was positive for occult lymph node disease in 25% to 60% of melanomas, 18,27,43,47,48,50,51 a higher rate than the 12% to 36% in melanomas >1 mm reported in adults.…”

Use of sentinel lymph node biopsy for melanoma in children and adolescents

“…Melanoma accounts for 1-3% of all pediatric malignancies, and there are over 300 new cases diagnosed in children each year in the United States [1]. The incidence of invasive melanoma is increasing more rapidly than any other malignancy in the United States, and this trend includes the pediatric population [2,3].…”

“…Little is known about the utilization of SLNB in children with reported rates ranging from 12% to 33% in single institution studies [5,15,16]. The objectives of this study were (1) to assess the utilization of SLNB in children with melanoma, (2) to determine clinicopathologic, socioeconomic, or hospital level factors associated with SLNB use, and (3) to identify factors associated with lymph node metastases (LNM) in children with melanoma.…”