As melanoma rates increase worldwide, older white men continue to have the highest rates of the disease and the worst outcomes, showing that prevention and early detection strategies need to be better targeted to this group.
At the recent World Congress on Cancers of the Skin in Edinburgh, Scotland, researchers from Public Health England presented data showing that melanoma rates are rising fastest in the UK’s older male population. From 1990 to 2010, men age 60 and over had an alarming 12 percent increase in melanoma incidence, compared to a nine percent increase in older women and eight percent in young men. The study also found that older men are being diagnosed with a higher rate of thick, advanced tumors than other groups. One reason for the delay in diagnosis in men could be that their melanomas often appear on the back, an area that is difficult to monitor for skin changes.
In the US, melanoma trends in older white men are similar. They have the highest melanoma rates, the thickest tumors, and the greatest likelihood of dying from the disease. Current melanoma incidence in older white men (65 and older) is about five times that of the general population, according to the Surveillance Epidemiology and End Results (SEER) program, the national registry of cancer data. In 2011, melanoma incidence for older white men was 168 cases per 100,000 compared to 21 cases per 100,000 in the general population.
Older men are highly susceptible to melanoma for a multitude of reasons. Over a lifetime, men spend more time outdoors accumulating ultraviolet exposure (a key cause of melanoma), and are less diligent about wearing sun protection, performing skin self-exams and visiting their doctors for check- ups. Researchers are also discovering that melanoma may behave differently in each gender; men’s tumors (possibly for hormonal reasons) may grow more rapidly than women’s, and their inferior immune response to the disease may put them at a disadvantage.
Experts on both sides of the pond agree that better skin cancer prevention messaging needs to reach older men, urging sun protection and early detection. “It will soon become a major concern for an increasingly aging population and health-care providers,” writes Dr. Eleni Linos in a 2009 Journal of Investigative Dermatology report. “Secondary prevention through early detection of melanoma is especially important in reducing mortality in high-risk groups” – older men being the largest high-risk group of all.
The biennial World Congress on Cancers of the Skin was founded by the Skin Cancer Foundation in 1983.
Published on November 3, 2014