Opinion statement
Melanoma incidence has continued to increase in all white populations, and mortality from melanoma remains high in older men worldwide. In Australia, Europe, and the United States, a substantial number of thick melanomas in older men are of the nodular subtype, a subtype lacking asymmetry or color change. Educating the public and pro-fessionals about the significance of evolving pigmented lesions as emphasized in the revised ABCDE of pigmented lesions is relevant. Targeting screening efforts toward older men will be necessary to decrease worldwide melanoma mortality. Among preven-tion strategies, emphasizing multiple methods of sun protection in early childhood, adolescence, and adulthood is needed to decrease sunburn rates. Chemoprevention research in melanoma should become a research priority to complement ongoing prevention strategies.
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References and Recommended Reading
Lens MB, Dawes M: Global perspectives of contemporary epidemiological trends of cutaneous malignant mela-noma. Br J Dermatol 2004, 150:179–185.
Jhappan C, Noonan FP, Merlino G: Ultraviolet radia-tion and cutaneous malignant melanoma. Oncogene 2003, 22:3099–3112.
Nelemans PJ, Groenendal H, Kiemeney LA: Effect of intermittent exposure to sunlight on melanoma risk among indoor workers and sun-sensitive individuals. Environ Health Perspect 1993, 101: 252.
Elwood JM, Gallagher RP, Hill GB, Pearson JC: Cutaneous melanoma in relation to intermittent and constant sun exposure--The Western Canada Melanoma Study. Int J Cancer 1985, 35:427.
Armstrong BK, Kricker A: How much melanoma is caused by sun exposure. Melanoma Res 1993, 3:395–401.
Tucker MA, Goldstein AM: Melanoma etiology: where are we. Oncogene 2003, 22:3042–3052.
van der Velden PA, Sandkuijl LA, Bergman W, et al.: Melanocortin-1 receptor variant R151C modifies melanoma risk in Dutch families with melanoma. Am J Hum Genet 2001, 69:774–779.
Whiteman DC, Watt P, Purdie DM, et al.: Melanocytic nevi, solar keratoses, and divergent pathways to cuta-neous melanoma. J Natl Cancer Inst 2003, 95:806–812. This study provides support for divergent pathways to cutaneous melanoma.
Curtin JA, Fridlyand J, Kageshita T, et al.: Distinct sets of genetic alterations in melanoma. N Engl J Med 2005, 353:2135–2147. This is the first detailed report highlighting genetic diversity in cutaneous melanoma.
Jemal A, Murray T, Ward E, et al.: Cancer statistics, 2005. CA Cancer J Clin 2005, 55:10–30.
Geller AC, Miller DR, Annas GD, et al.: Melanoma inci-dence and mortality among US whites, 1969-1999. JAMA 2002, 288:1719–1720.
Jemal A, Devesa SS, Hartge P, Tucker MA: Recent trends in cutaneous melanoma incidence among whites in the United States. J Natl Cancer Inst 2001, 93:678–683.
Demierre MF, Chung C, Miller DR, Geller AC: Early detection of thick melanomas in the US? “Beware≓ of the nodular subtype. Arch Dermatol 2005, 141:745–750.
Chamberlain AJ, Fritschi L, Giles GG, et al.: Nodular type and older age as the most significant associations of thick melanoma in Victoria, Australia. Arch Dermatol 2002, 138:609–614.
Bergenmar M, Ringborg U, Mansson Brahme E, Brandberg Y: Nodular histogenetic type--the most significant factor for thick melanoma: implications for prevention. Melanoma Res 1998, 8:403–411.
Crocetti E, Carli P: Changes from mid-1980s to late 1990s among clinical and demographic correlates of melanoma thickness. Eur J Dermatol 2003, 13:72–75.
Swetter SM, Boldrick JC, Jung SY, et al.: Increasing incidence of lentigo maligna melanoma subtypes: northern California and national trends 1990-2000. J Invest Dermatol 2005, 125:685–691.
MacKie R: Melanoma incidence in the west of Scotland over 25 years. Proceedings of the 6th World Congress on Melanoma. Vancouver, Canada, September 6–10 2005.
de Vries E, Bray FI, Coebergh JW, Parkin DM: Changing epidemiology of malignant cutaneous melanoma in Europe 1953-1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia. Int J Cancer 2003, 107: 119–126.
de Vries E, Schouten LJ, Visser O, et al.: Rising trends in the incidence of and mortality from cutaneous mela-noma in the Netherlands: a Northwest to Southeast gradient. Eur J Cancer 2003, 39:1439–1446.
Edwards BK, Brown ML, Wingo PA, et al.: Annual report to the nation on the status of cancer, 1975-2002, featuring population-based trends in cancer treat-ment. J Natl Cancer Inst 2005, 97:1407–1427.
deVries E, Bray FI, Coebeergh JWW, Parkin DM: Changing epidemiology of malignant cutaneous melanoma in Europe 1953-1997: rising trends in incidence and mor-tality but recent stabilizations in Western Europe and decreases in Scandinavia. Int J Cancer 2003, 107: 119–126.
Bosetti C, La Vecchia C, Naldi L, et al.: Mortality from cutaneous malignant melanoma in Europe. Has the epidemic leveled off? Melanoma Res 2004, 14:301–309.
Cayuela A, Rodriguez-Dominguez S, Lapetra-Peralta J, Conejo-Mir JS: Has mortality from malignant melanoma stopped rising in Spain? Analysis of trends between 1975 and 2001. Br J Dermatol 2005, 152:997–1000.
Geller AC, Sober AJ, Zhang Z, et al.: Strategies for improving melanoma education and screening for men age > or = 50 years: findings from the American Academy of Dermatological National Skin Cancer Screening Program. Cancer 2002, 95:1554–1561.
Lindelof B, Sigurgeirsson B, Gabel H, Stern RS: Incidence of skin cancer in 5356 patients following organ trans-plantation. Br J Dermatol 2000, 143:513–519.
Hollenbeak CS, Todd MM, Billingsley EM, et al.: Increased incidence of melanoma in renal transplantation recipi-ents. Cancer 2005, 104: 1962–1967.
Strouse JJ, Fears TR, Tucker MA, Wayne AS: Pediatric melanoma: risk factor and survival analysis of the surveillance, epidemiology and end results database. J Clin Oncol 2005, 23:4735–4741.
Hu S, Ma F, Collado-Mesa F, Kirsner RS: UV radiation, latitude, and melanoma in US Hispanics and blacks. Arch Dermatol 2004, 140:819–824.
Eide MJ, Weinstock MA: Association of UV index, lati-tude, and melanoma incidence in nonwhite popula-tions—US Surveillance, Epidemiology, and End Results (SEER) Program, 1992-2001. Arch Dermatol 2005, 141:477–481.
Berwick M, Armstrong BK, Ben-Porat L, et al.: Sun expo-sure and mortality from melanoma. J Natl Cancer Inst 2005, 97:195–199. A study eliciting novel hypotheses in regard to chronic sun exposure and melanoma.
Webb AR, DeCosta BR, Holick MF: Sunlight regulates the cutaneous production of vitamin D3 by causing its photodegradation. J Clin Endocrinol Metab 1989, 68:882–887.
Egan KM, Sosman JA, Blot WJ: Sunlight and reduced risk of cancer: is the real story vitamin D. J Natl Cancer Inst 2005, 97:161–163.
Lim HW, Gilchrest BA, Cooper KD, et al.: Sunlight, tan-ning booths, and vitamin D. J Am Acad Dermatol 2005, 52:868–876.
Rhodes AR: Public education and cancer of the skin. What do people need to know about melanoma and nonmelanoma skin cancer. Cancer 1995, 75:613.
Godar DE, Urback F, Gasparro FP, van der Leun JC: UV doses of young adults. Photochem Photobiol 2003, 77:453–457. A relevant update on actual amount of UV exposure received by each age group.
Robinson JK, Rigel DS, Amonette RA: Trends in sun exposure knowledge, attitudes, and behaviors: 1986 to 1996. J Am Acad Dermatol 1997, 37:179–186.
Benjes LS, Brooks DR, Zhang Z, et al.: Changing patterns of sun protection between the first and second sum-mers for very young children. Arch Dermatol 2004, 140:925–930.
McGuire-Eisen M, Rothman K, Demierre MF: The ABCs of sun protection for children. Dermatol Nurs 2006, In press.
Gallagher RP, Rivers JK, Lee TK, et al.: Broad-spectrum sunscreen use and the development of new nevi in white children: a randomized controlled trial. JAMA 2000, 283:2955–2960.
Diffey BL: Sunscreens and melanoma: the future looks bright. Br J Dermatol 2005, 153:378–381.
Mahler HI, Kulik JA, Harrell J, et al.: Effects of UV photo-graphs, photoaging information, and use of sunless tan-ning lotion on sun protection behaviors. Arch Dermatol 2005, 141:373–380.
Lindholm C, Andersson R, Dufmats M, et al.: Invasive cutaneous malignant melanoma in Sweden, 1990-1999. A prospective, population-based study of survival and prognostic factors. Cancer 2004, 101: 2067–2078.
Institute of Medicine: Extending Medicare Coverage for Prevention and Other Services. Washington DC: National Academy Press; 2000.
Abbasi NR, Shaw HM, Rigel DS, et al.: Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria. JAMA 2004, 292:2771–2776.
Demierre MF, Nathanson L: Chemoprevention of mela-noma: an unexplored strategy. J Clin Oncol 2003, 21: 158–165.
Edwards BK, Howe HL, Ries LA, et al.: Annual report to the nation on the status of cancer, 1973-1999, featuring implications of age and aging on U.S. cancer burden. Cancer 2002, 94:2766–2792.
Lippman SM, Hong WK: Cancer prevention science and practice. Cancer Res 2002, 62:5119–5125.
Demierre MF, Sondak VK: Cutaneous melanoma: patho-genesis and rationale for chemoprevention. Crit Rev Oncol Hematol 2005, 53:225–239. An important review on the rationale for chemoprevention in melanoma.
Demierre MF, Lippman SM, Higgins P, Gruber S: Statins and cancer prevention. Nat Rev Cancer 2005, 5:930–942.
Demierre MF, Sondak VK: Chemoprevention of mela-noma: theoretical and practical considerations. Cancer Control J 2005, 12:219–222.
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Demierre, MF. Epidemiology and prevention of cutaneous melanoma. Curr. Treat. Options in Oncol. 7, 181–186 (2006). https://doi.org/10.1007/s11864-006-0011-z
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DOI: https://doi.org/10.1007/s11864-006-0011-z