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Risk factors for the development of melanoma

Author
Clara Curiel-Lewandrowski, MD
Section Editors
Michael B Atkins, MD
Hensin Tsao, MD, PhD
Deputy Editor
Rosamaria Corona, MD, DSc

INTRODUCTION

Melanoma is the most serious form of skin cancer. The rapid increase in the incidence of melanoma and its associated mortality require a detailed understanding of the risk factors associated with melanoma.

Here we will review epidemiologic changes in the incidence and mortality, specific risk factors, and the management of patients at high risk for the development of melanoma. Primary prevention, screening, and techniques of skin examination are discussed separately. (See "Primary prevention of melanoma" and "Screening and early detection of melanoma" and "Clinical features and diagnosis of cutaneous melanoma".)

EPIDEMIOLOGY

The incidence of melanoma is rising dramatically, and despite efforts at screening, mortality has not decreased appreciably. Understanding the epidemiology provides information about important causative factors.

Incidence — In the United States, melanoma is the fifth leading cancer in men and the seventh in women [1]. In 2011, the overall age-adjusted incidence of melanoma was 19.7 per 100,000 [2]. From 1982 to 2011, melanoma incidence rates doubled in the United States, while mortality rates remained constant [2]. The incidence rates increased with age and were highest among non-Hispanic whites (24.6 per 100,000). Among white individuals, the incidence rates of invasive melanoma were 27.4/100,000 men and 16.7/100,000 women per year in the years 2006 to 2010 [3]. Lentigo maligna melanoma has been increasing at a higher rate compared with other subtypes of melanoma combined for patients aged 45 and older [4]. However, the incidence of melanoma in the United States may be underestimated because many cases diagnosed and treated in private practices are not reported to cancer registries [5,6].

The incidence of melanoma is also rising worldwide. The estimated age-standardized incidence rates of melanoma in men and women worldwide increased from 2.3 and 2.2/100,000 people, respectively, in 1990 to 3.1 and 2.8/100,000 people in 2008 [7,8]. Between the early 1970s and 2000, the estimated incidence of melanoma in Central Europe increased from 3 to 4 cases/100,000 inhabitants per year to 10 to 15 cases/100,000 inhabitants per year [9]. In contrast to North America and Australia, European incidence rates of melanoma in females exceed those in men [10].

                        

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