Women and Melanoma: Its Getting Scarier

concernedwomanIt is well known that young women in the U.S. have recently had significant increases in the two most common non-melanoma skin cancers, basal and squamous cell carcinoma. Now the same appears true for melanoma, the deadliest form of skin cancer. A report from the National Cancer Institute appearing in the Journal of Investigative Dermatology (JID) reveals startling melanoma trends among young Caucasian women. Melanoma incidence had been skyrocketing among older adults for decades, but it wasn't until the 2001 publication of a study from the Surveillance, Epidemiology, and End Results (SEER) program, covering the period from 1973 to 1997, that a melanoma increase was seen among Caucasian women born after 1960. Now, seven more years of SEER data — through 2004 — have produced even more definitive findings.

In the period from 1973 to 2004, melanoma incidence among men aged 15 to 39 increased from 4.7 cases to 7.7 cases per 100,000. In that same age group, the figures more than doubled among women, leaping from 5.5 cases per 100,000 in 1973 to 13.9 in 2004. After soaring in the 1970s, the rate of increase in women had actually declined from 1978 to 1987, but it began increasing again after 1992.

Many experts believe that the reported increases in melanoma incidence are partly a blessing because they mean we have become better at detecting melanoma, especially at early stages. And the great majority of cases are found early, when they are most curable. However, alarmingly, more advanced cases are being found in women as well. From the 1990s on, cases in Caucasian women increased both for thin (1mm), more worrisome melanomas, as well as highly dangerous melanomas that had spread.

These changes, the authors point out, parallel reported increases in exposure to ultraviolet radiation (UVR), "the primary environmental cause of melanoma" according to the landmark study by Armstrong and Kricker in 2001. The authors also noted that in sun surveys taken from 1998 to 2004, the prevalence of sunburn and the average number of days spent at the beach increased (most notably among adolescents 16-18 years old), representing the patterns of sun exposure considered to be most likely to cause melanoma. Similarly, tanning bed usage, recently found to be a probable cause of melanoma by the International Agency for Research on Cancer, has been rapidly increasing among U.S. adults, and is most prevalent among young women.

"While more research is needed to confirm the link between melanoma and UVR exposure, this study shows that melanoma is becoming an ever greater danger for young women, and strongly suggests concrete, effective ways to minimize the danger — namely, protect yourself against the sun, and stay out of tanning booths," concluded Perry Robins, MD, President of The Skin Cancer Foundation.

The Foundation advises everyone to make these sun safety habits part of their daily health care:

  • Seek the shade, especially between 10 AM and 4 PM.
  • Do not burn.
  • Avoid tanning and UV tanning booths.
  • Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
  • Use a sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB)
    sunscreen with an SPF of 30 or higher.
  • Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or after swimming or excessive sweating.
  • Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
  • Examine your skin head-to-toe every month.
  • See your doctor every years for a professional skin exam.