Diseases of the Colon & Rectum

, Volume 42, Issue 9, pp 1203–1208 | Cite as

Changing epidemiology of anorectal melanoma

  • Burt Cagir
  • Mark H. Whiteford
  • Allan Topham
  • Jan Rakinic
  • Robert D. Fry
Original Contributions


PURPOSE: We reviewed 117 cases of anorectal melanoma to better define epidemiologic and survival characteristics of this rare neoplasm. METHODS: The National Cancer Institute Surveillance, Epidemiology, and End Results database covering the period 1973 through 1992 was used. This represents 9.5 percent of the United States population. Melanoma arising in the anorectum was identified using International Classification of Diseases for Oncology codes. Two-tailed Student'st-test, chi-squared, and Wilcoxon's tests were used for comparisons of means, proportions, and actuarial survival rates, respectively. RESULTS: One hundred seventeen cases of anorectal melanoma were identified, representing 0.048 percent of all colorectal malignancies in the database. The male-to-female ratio was 1:1.72. The mean age was 66±16 years. Mean age by gender, however, was lower for males (57 years) then for females (71 years;P<0.001). The age difference represents an increased incidence of anorectal melanoma in males younger than the age of 45 years. Furthermore, the incidence of anorectal melanoma in young males ages between 25 to 44 years tripled in the San Francisco area when compared with all other locations (14.4vs. 4.8 per 10 million population;P=0.06). Males have a survival advantage over females (62.8 percentvs. 51.4 percent 1-year and 40.6 percentvs. 27.7 percent 2-year;P<0.01). CONCLUSIONS: The overall incidence of anorectal melanoma continues to rise and survival rates remain poor. A new trend toward bimodal age distribution was observed. There is indirect evidence that implicates human immunodeficiency virus infection as a risk factor. Survival rate is better in young patients aged 25 to 44 years.

Key words

Anorectal melanoma Melanoma Anal neoplasm Anal cancer HIV AIDS 


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  1. 1.
    Moore, W. Recurrent melanoma of the rectum after previous removal from the verge of the anus in a man aged sixty-five. Lancet 1857;1:290.Google Scholar
  2. 2.
    Thibault C, Sagar P, Nivatvongs S, Ilstrup DM, Wolff BG. Anorectal melanoma: an incurable disease? Dis Colon Rectum 1997;40:661–8.Google Scholar
  3. 3.
    Roumen RM. anorectal melanoma in the Netherlands: a report of 63 patients. Eur J Surg Oncol 1996;22:598–601.Google Scholar
  4. 4.
    Brady MS, Kavolius JP, Quan SH. Anorectal melanoma: a 64-year experience at Memorial Sloan-Kettering Cancer Center. Dis Colon Rectum 1995;38:146–51.Google Scholar
  5. 5.
    Bolivar JC, Harris JW, Branch W, Sherman RT. Melanoma of the anorectal region. Surg Gynecol Obstet 1982;154:337–41.Google Scholar
  6. 6.
    Surveillance, Epidemiology, and End Results (SEER) Program public use CD-ROM (1973–1992), National Cancer Institute, DCPC, Surveillance Program, Cancer Statistics Branch, Bethesda, Maryland, November 1995.Google Scholar
  7. 7.
    Miller BA, Ries LAG, Hankey BF,et al., eds. SEER Cancer Statistics Review: 1973–1990. DHHS Publ. No. 93-2789. 1993;1:I1–22.Google Scholar
  8. 8.
    Weinstock MA. Epidemiology and prognosis of anorectal melanoma. Gastroenterology 1993;104:174–8.Google Scholar
  9. 9.
    Reynolds P, Saunders LD, Layefsky ME, Lemp GF. The spectrum of acquired immunodeficiency syndrome (AIDS)-associated malignancies in San Francisco, 1980–1987. Am J Epidemiol 1993;137:19–30.Google Scholar
  10. 10.
    Eby NL, Grufferman S, Flannelly CM, Schold SC, Vogel FS, Burger PC. Increasing incidence of primary brain lymphoma in the US. Cancer 1998;62:2461–5.Google Scholar
  11. 11.
    Coté RT, Manns A, Hardy CR, Yellin FJ, Hartge P. Epidemiology of brain lymphoma among people with or without acquired immunodeficiency syndrome. J Natl Cancer Inst 1996;88:675–9.Google Scholar
  12. 12.
    Corn BW, Marcus SM, Topham A, Hauck W, Curran WJ. Will primary central nervous system lymphoma be the most frequent brain tumor diagnosed in the year 2000? Cancer 1997;79:2409–13.Google Scholar
  13. 13.
    Wang C-Y, Brodland DG, Daniel Su WP. Skin cancers associated with acquired immunodeficiency syndrome. Mayo Clin Proc 1995;70:766–72.Google Scholar
  14. 14.
    McGregor JM, Newell M, Ross J, Kirkham N, McGibbon DH, Darley C. Cutaneous malignant melanoma and human immunodeficiency virus (HIV) infection. A report of a three cases. Br J Dermatol 1992;126:516–9.Google Scholar
  15. 15.
    Van Ginkel CJ, Sang RT, Blaauwgeers JL, Schattenkerk JK, Mooi WJ, Hulsebosch HJ. Multiple primary malignant melanomas in an HIV-positive man. J Am Acad Dermatol 1991;24:284–5.Google Scholar
  16. 16.
    Merkle T, Braun-Falco O, Froschl M, Ruzicka T, Landthaler M. Malignant melanoma in human immunodeficiency virus type 2 infection [letter]. Arch Dermatol 1991;127:266–7.Google Scholar
  17. 17.
    Rivers JK, Kopf AW, Postel AH. Malignant melanoma in a man seropositive for the human immunodeficiency virus. J Am Acad Dermatol 1989;20:1127–8.Google Scholar
  18. 18.
    Tindall B, Finlayson R, Mutimer K, Billson FA, Munro VF, Cooper DA. Malignant melanoma associated with human immunodeficiency virus infection in three homosexual men. J Am Acad Dermatol 1989;20:587–91.Google Scholar
  19. 19.
    Krause W, Mittag H, Gieler U, Thomas E, Wichmann U. A case of malignant melanoma in AIDS-related complex [letter]. Arch Dermatol 1987;123:867–8.Google Scholar
  20. 20.
    Gupta S, Imam A. Malignant melanoma in a homosexual man with HTLV-III/LAV exposure. Am J Med 1987;82:1027–30.Google Scholar
  21. 21.
    Moore GE, Cook DD. AIDS in association with malignant melanoma and Hodgkin's disease [letter]. J Clin Oncol 1985;3:1437.Google Scholar
  22. 22.
    Duvic M, Lowe L, Rapini RP, Rodriguez S, Levy ML. Eruptive dysplastic nevi associated with human immunodeficiency virus infection. Arch Dermatol 1989;125:397–401.Google Scholar
  23. 23.
    Stidham KR, Johnson JL, Seigler HF. Survival superiority of females with melanoma. A multivariate analysis of 6383 patients exploring the significance of gender in prognostic outcome. Arch Surg 1994;129:316–24.Google Scholar

Copyright information

© The American Society of Colon and Rectal Surgeons 1999

Authors and Affiliations

  • Burt Cagir
    • 1
  • Mark H. Whiteford
    • 1
  • Allan Topham
    • 2
  • Jan Rakinic
    • 1
  • Robert D. Fry
    • 1
  1. 1.From the Department of SurgeryJefferson Medical CollegeUSA
  2. 2.Oncology Data ServicesThomas Jefferson University HospitalPhiladelphia

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