Melanoma in women of childbearing age and in pregnancy in California, 1994–2015: a population‐based cohort study

Abstract

Background Melanoma is one of the most common malignancies during pregnancy. There is debate regarding the impact of pregnancy on the prognosis of melanoma. Recent large population‐based studies from the United States are lacking. Objectives To determine the characteristics and survival of women with pregnancy‐associated melanoma. Methods This population‐based, retrospective cohort study used California Cancer Registry data linked with state‐wide hospitalization and ambulatory surgery data to identify 15–44‐year‐old female patients diagnosed with melanoma in 1994–2015, including pregnant patients. Multivariable logistic regression compared demographic and clinical characteristics between pregnant and non‐pregnant women with melanoma. Multivariable cox proportional hazards regression models assessed melanoma‐specific and overall survival. Results We identified 13 108 patients, of which 1406 were pregnant. Pregnancy‐associated melanoma was more frequent in Hispanic compared to non‐Hispanic White women. Melanoma occurring post‐partum was associated with greater tumour thickness (2.01–4.00 vs. 0.01–1.00 mm, odds ratio 1.75, 95% confidence interval: 1.03–2.98). There were otherwise no significant differences between pregnant and non‐pregnant women. Worse survival was associated with Asian, Black and Native American race/ethnicity (vs. non‐Hispanic White), lower neighbourhood socio‐economic status, public insurance, tumour site, greater tumour thickness and lymph node involvement, but not pregnancy. Conclusions Melanoma occurring post‐partum was associated with greater tumour thickness, but pregnancy status did not affect survival after melanoma. Race/ethnicity, socio‐economic status and health insurance impacted survival, emphasizing the importance of reducing health disparities.

Nodular Malignant Melanoma on the Abdomen of a Lactating Lady

“…Another observation was that demographic, clinical, histological characteristics and management were identical for both PAM and non-PAM. 14…”

“…Another observation was that demographic, clinical, histological characteristics and management were identical for both PAM and non-PAM. 14 Van Rooij et al reported a case of an Australian, Fitzpatrick skin type 1 woman with dysplastic nevus syndrome who, over 15 years, developed nine MMs, with eight clustered around an 18-month perinatal-postpartum period. Of the nine MMs, the first eight MMs were in situ lesions, and the ninth was invasive melanoma.…”

Highlights from the Journal of the European Academy of Dermatology and Venereology in 2022

“…It was also associated with increased thickness (2–4 mm), whereas decreased survival was linked to a lower social‐economic status rather than pregnancy. The authors concluded that post‐partum melanoma represents a health disparity problem with regard to socioeconomic factors 8 …”

“…The authors concluded that post-partum melanoma represents a health disparity problem with regard to socioeconomic factors. 8 This underscores the importance of preventative measures such as photoprotection. The striking image of a 92-year-old woman showing rather unblemished skin on her face and severe photoaging in the neck region demonstrates the effectiveness of sunscreens.…”