Melanoma pp 249-269 | Cite as

Epidemiology of Melanocytic Neoplasia

  • Margaret Anne TuckerEmail author
Reference work entry


Cutaneous melanoma has increased rapidly worldwide over the past 60 years, moving from a rare cancer to one of the most common in the USA. This epidemic has led to epidemiologic and clinical studies to elucidate risk factors for cutaneous melanoma. The risk of melanoma varies by race and ethnicity. Lower socioeconomic status is associated with more advanced melanoma at the time of diagnosis. Identified risk factors for cutaneous melanoma include ultraviolet light exposure (sun and artificial) and host susceptibility factors such as family history of melanoma, dysplastic nevi, increased number of nevi, light pigmentation (skin, hair, and eyes), and immunosuppression. Comprehensive sun/ultraviolet radiation (UV) protection measures, such as those implemented in Australia since the 1990s, are now showing an impact with decreasing incidence of cutaneous melanoma. Mucosal melanoma is distinct from cutaneous melanoma and does not appear to be UV-related. No known risk factors have been identified except for race and gender. Ocular melanoma is also a distinct entity with less evidence of UV exposure as a risk factor than for cutaneous. Host factors include light pigmentation and choroidal/iris nevi. Reciprocal increases in ocular and cutaneous melanoma suggest some common risk factors.


Incidence Mortality Survival Risk factors Nevi Cutaneous melanoma Mucosal melanoma Ocular melanoma 


  1. Amini A, Rusthoven CG, Waxweiler TV, Jones BJ, Fisher CM, Raben D (2016) Association of health insurance with outcomes in adults ages 18–64 years with melanoma in the United States. J Am Acad Dermatol 74:309–316. Scholar
  2. Andreoli MT, Mieler WF, Leiderman YI (2015) Epidemiologic trends in uveal melanoma. Br J Ophthalmol 99:1550–1553. Scholar
  3. Bastian BC (2014) The molecular pathology of melanoma: an integrated taxonomy of melanocytic neoplasia. Annu Rev Pathol Mech Dis 9:239–271. Scholar
  4. Bradford PT, Anderson WF, Purdue MP, Goldstein AM, Tucker MA (2010) Rising melanoma incidence rates of the trunk among younger women in the United States. Cancer Epidemiol Biomark Prev 19:2401–2406. Scholar
  5. Brecht IB, Garbe C, Gefeller O, Pfahlberg A, Bauer J, Eigentler TK, Offenmueller S, Schneider DT, Leiter U (2015) 443 paediatric cases of malignant melanoma registered with the German central malignant melanoma registry between 1983 and 2011. Eur J Cancer 51:861–868. Scholar
  6. Byrom L, Olsen C, Knight L, Khosrotehrani K, Green AC (2015) Increased mortality for pregnancy-associated melanoma: systematic review and meta-analysis. JEADV 29:1457–1466. Scholar
  7. Callahan A, Anderson WF, Patel S, Barnholtz-Sloan JS, Bordeaux JS, Tucker MA, Gerstenblith MR (2016) Epidemiology of anorectal melanoma in the United States: 1992–2011. Dermatol Surg 42:94–99. Scholar
  8. Campbell LB, Kreicher KL, Gittleman HR, Strodtbeck K, Barnholtz-Sloan J, Bordeaux JS (2015) Melanoma incidence in children and adolescents: decreasing trends in the United States. J Pediatr 116:1505–1513. Scholar
  9. Carney PA, Frederick PD, Reisch LM, Knezevich S, Piepkorn MW, Barnhill RL, Elder DE, Geller BM, Titus L, Weinstock MA, Nelson HD, Elmore JG (2016) How concerns and experiences with medical malpractice affect dermatopathologists’ perceptions of their diagnostic practices when interpreting cutaneous melanocytic lesions. J Am Acad Dermatol 74:317–324. Scholar
  10. Clegg LX, Feuer EJ, Midthune DN, Fay MP, Hankey BF (2002) Impact of reporting delay and reporting error on cancer incidence rates and trends. J Natl Cancer Inst 94:1537–1545. Scholar
  11. Colantonia S, Bracken MB, Beecker J (2014) The association of indoor tanning and melanoma in adults: systematic review and meta-analysis. J Am Acad Dermatol 70:847–857. Scholar
  12. Curtis RE, Freedman DM, Ron E, Ries LAG, Hacker DG, Edwards BK, Tucker MA, Fraumeni JF Jr (2006) New malignancies among cancer survivors: SEER cancer registries, 1973–2000. NIH Publ. No. 05-5302. National Cancer Institute, BethesdaGoogle Scholar
  13. Cust AE, Armstrong BK, Goumas C, Jenkens MA, Schmid H, Hopper JL, Kefford RF, Giles GG, Aitken JF, Mann GJ (2011) Sunbed use during adolescence and early adulthood is associated with increased risk of early-onset melanoma. Int J Cancer 128:2425–2435. Scholar
  14. El Ghissassi F, Baan R, Straif K, Grosse Y, Secretan B, Bouvard V, Benbrahim-Tallaa L, Guha N, Freeman C, Galichet L, Cogliano V, on behalf of the WHO International Agency for Research on Cancer Monograph Working Group (2009) A review of human carcinogens – part D: radiation. Lancet Oncol 10:751–752. Scholar
  15. English DR, Milne E, Simpson JA (2005) Sun protection and the development of melanocytic nevi in children. Cancer Epidemiol Biomark Prev 14:2873–2876. Scholar
  16. Fell GL, Robinson KC, Mao J, Woolf CJ, Fisher DE (2014) Skin β-endorphin mediates addiction to UV light. Cell 157:1527–1534. Scholar
  17. Gandini S, Sera F, Cattaruzza MF, Pasquini P, Picconi O, Boyle P, Melchi CF (2005) Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer 41:45–60. Scholar
  18. Geller AC, Clapp RW, Sober AJ, Gonsalves L, Mueller L, Christiansen CL, Shaikh W, Miller DR (2013) Melanoma epidemic: an analysis of six decades of data from the Connecticut tumor registry. J Clin Oncol 33:4172–4178. Scholar
  19. Geller AC, Swetter SM, Weinstock MA (2015) Focus on early detection to reduce melanoma deaths. J Invest Dermatol 135:947–949. Scholar
  20. Guy GP, Thomas CC, Thompson T, Watson M, Massetti GM, Richardson LC (2015) Vital signs: melanoma incidence and mortality trends and projections- United States, 1982–2030. MMWR 64:591–596. Scholar
  21. Helvind NM, Holmich LR, Smith S, Glud M, Andersen KK, Dalton SO, Drzewiecki KT (2015) Incidence of in situ and invasive melanoma in Denmark from 1985 through 2012: a national database study of 24059 melanoma cases. JAMA Dermatol 151:1087–1095. Scholar
  22. Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds) (2015) SEER cancer statistics review, 1975–2012. National Cancer Institute, Bethesda. Based on November 2014 SEER data submission, posted to the SEER web site, Apr 2015. Accessed 26 Dec 2015Google Scholar
  23. Khosrotehrani K, Dasgupta P, Byrom L, Youlden DR, Baade PD, Green AC (2015) Melanoma survival is superior in females across all tumor stages but is influenced by age. Arch Dermatol Res 307:731–740. Scholar
  24. Lazova R, Pornputtapong N, Halaban R, Bosenberg M, Bai Y, Chai H, Krauthammer M (2017) Mod Pathol 30:640–649. Scholar
  25. Lazovich D, Vogel RI, Berwick M, Weinstock MA, Anderson KE, Warshaw EM (2010) Indoor tanning and risk of melanoma: a case-control study in a highly exposed population. Cancer Epidemiol Biomarkers Prev 19:1557–1568. Scholar
  26. Lott JP, Wititsuwannakul J, Lee JJ, Ariyan S, Narayan D, Kluger HH, Lazova R (2014) Clinical characteristics associated with Spitz nevi and Spitzoid malignant melanomas: the Yale University Spitzoid neoplasm repository experience, 1991–2008. J Am Acad Dermatol 71:1077–1082. Scholar
  27. McLaughlin CC, Wu XC, Jemal A, Martin HJ, Roche LM, Chen VW (2005) Incidence of non-cutaneous melanoma in the U.S. Cancer 103:1000–1007. Scholar
  28. Nielsen K, Masback A, Olsson H, Ingvar C (2012) A prospective population-based study of 40,000 women regarding host factors, UV exposure and sunbed use in relation to risk and anatomic site of melanoma. Int J Cancer 131:706–715. Scholar
  29. Park SL, Le Marchand L, Wilkens LR, Kolonel LN, Henderson BE, Zhang ZF, Setiawen VW (2012) Risk factors for malignant melanoma in white and non-white/non-African American populations, the multiethnic cohort. Cancer Prev Res 5:423–434. Scholar
  30. Petersen B, Triguero-Mas M, Maier B, Thieden E, Philipsen PA, Heydenreich J, Dadvand P, Maier H, Grage MML, Harrison GI, Schmalwieser AW, Nieuwenhuijsen MJ, Young AR, Wulf HC (2015) Sun behavior and personal UVR exposure among Europeans on short term holidays. J Photochem Photobiol B: Biol 151:264–269. Scholar
  31. Pollitt RA, Clarke CA, Swetter SM, Peng DH, Zadnick J, Cockburn M (2011) The expanding melanoma burden in California Hispanics. Cancer 117:152–161. Scholar
  32. Pomerantz H, Huang D, Weinstock MA (2015) Risk of subsequent melanoma after melanoma in situ and invasive melanoma: a population-based study from 1973 to 2011. J Am Acad Dermatol 72:794–800. Scholar
  33. Qiu M, Shields CL (2015) Choroidal nevus in the United States adult population: racial disparities and associated factors in the national health and nutrition examination survey. Ophthalmology 122:2071–2083. Scholar
  34. Richardson BS, Anderson WF, Barnholtz-Sloan JS, Tucker MA, Gerstenblith MR (2014) The age-specific effect modification of male sex for ulcerated cutaneous melanoma. JAMA Dermatol 150:522–525. Scholar
  35. Robbins HA, Clarke CA, Arron ST, Tatalovich Z, Kahn AR, Hernandez BY, Paddock L, Yanik EL, Lynch CF, Kasiske BL, Snyder J, Engels EA (2015) Melanoma risk and survival among organ transplant recipients. J Invest Dermatol 135:2657–2665. Scholar
  36. Scope A, Dusza SW, Marghoob AA, Satagopan JM, Tavoloni JBC, Psaty EL, Weinstock MA, Oliveria SA, Bishop M, Geller AC, Halpern AC (2011) Clinical and dermoscopic stability and volatility of melanocytic nevi in a population-based cohort of children in Framingham school system. J Invest Dermatol 131:1615–1621. Scholar
  37. Shah CP, Weis E, Lajous M, Shields JA, Shields CL (2005) Intermittent and chronic ultraviolet light exposure and uveal melanoma. Ophthalmology 112:1599–1607. Scholar
  38. Shaikh WR, Weinstock MA, Halpern AC, Oliveria SA, Geller AC, Dusza SW (2013) The characterization and potential impact of melanoma cases with unknown thickness in the United States’ surveillance, epidemiology, and end results program, 1989–2008. Cancer Epidemiol 37:64–70. Scholar
  39. Shaikh WR, Dusza SW, Weinstock MA, Oliveria SA, Geller AC, Halpern AC (2016) Melanoma thickness and survival trends in the United States, 1989–2009. JNCI 108:djv294. Epub 12 Nov 2015
  40. Shields CL, Kaliki S, Livesey M, Walker B, Garoon R, Bucci M, Feinstein E, Pesch A, Gonzalez C, Lally SE, Mashayekhi A, Shields JA (2013) Association of ocular and oculodermal melanocytosis with the rate of uveal melanoma metastasis: analysis of 7872 consecutive eyes. JAMA Ophthal 131:993–1003. Scholar
  41. Tucker MA, Halpern A, Holly EA, Hartge P, Elder DE, Sagebiel RW, Guerry D IV, Clark WH Jr (1997) Clinically recognized dysplastic nevi: a central risk factor for cutaneous melanoma. JAMA 277:1439–1444. PMID:9145715CrossRefGoogle Scholar
  42. Tucker MA, Fraser MC, Goldstein AM, Struewing JP, King MA, Crawford JT, Chiazze EA, Zametkin DP, Fontaine LS, Clark WH Jr (2002) A natural history of melanomas and dysplastic nevi: an atlas of lesions in melanoma-prone families. Cancer 94:3192–3209. Scholar
  43. Vuong K, McGeechan K, Armstrong BK, Cust AE (2014) Risk prediction models for incident primary cutaneous melanoma: a systematic review. JAMA Dermatol 150:434–444. Scholar
  44. Wallingford SC, Iannocone MR, Youlden DR, Baade PD, Ives A, Verne J, Aitken JF, Green AC (2015) Comparison of melanoma incidence and trends among youth under 25 years in Australia and England, 1990–2010. Int J Cancer 137:2227–2233. Scholar
  45. Walter FM, Abel GA, Lyratzopoulos G, Melia J, Greenberg D, Brewster DH, Butler H, Corrie PG, Campbell C (2015) Seasonal variation in diagnosis of invasive cutaneous melanoma in eastern England and Scotland. Cancer Epidemiol 39:554–561. Scholar
  46. Warthan MM, Uchida T, Wagner RF Jr (2005) UV light tanning as a type of substance-related disorder. Arch Dermatol 141:963–966. PMID:16103324CrossRefGoogle Scholar
  47. Weis E, Shah CP, Lajous M, Shields JA, Shields CL (2006) The association between host susceptibility factors and uveal melanoma: a meta-analysis. Arch Ophthalmol 124:54–60. PMID 16401785CrossRefGoogle Scholar
  48. Whiteman DC, Pavan WJ, Bastian BC (2011) The melanomas: a synthesis of epidemiological, clinical, histopathological, genetic, and biological aspects, supporting distinct subtypes, causal pathways, and cell of origin. Pigment Cell Melanoma Res 24:879–897. Scholar
  49. Whiteman DC, Baade PD, Olsen CM (2015) More people die from thin melanomas (≤ 1mm) than from thick melanomas (>4mm) in Queensland, Australia. J Invest Dermatol 135:1190–1193. Scholar

Copyright information

© This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2019

Authors and Affiliations

  1. 1.Human Genetics Program, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaUSA

Section editors and affiliations

  • David E. Fisher
    • 1
  • Nick Hayward
    • 2
  • David C. Whiteman
    • 3
  • Keith T. Flaherty
    • 4
  • F. Stephen Hodi
    • 5
    • 6
  • Hensin Tsao
    • 7
    • 8
  • Glenn Merlino
    • 9
  1. 1.Department of Dermatology, Harvard/MGH Cutaneous Biology Research Center, and Melanoma Program, MGH Cancer CenterMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.QIMR Berghofer Medical Research InstituteHerstonAustralia
  3. 3.QIMR Berghofer Medical Research InstituteHerstonAustralia
  4. 4.Henri and Belinda Termeer Center for Targeted TherapiesMGH Cancer CenterBostonUSA
  5. 5.FraminghamUSA
  6. 6.Department of Medicine, Brigham and Women's HospitalDana-Farber Cancer InstituteBostonUSA
  7. 7.AuburndaleUSA
  8. 8.Harvard-MIT Health Sciences and TechnologyCambridgeUSA
  9. 9.Center for Cancer ResearchNational Cancer InstituteBethesdaUSA

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