Cases of melanoma dropped markedly among US teens and young adults from 2006 to 2015, research finds.
That trend occurred even as incidents of skin cancer continued to increase among older adults and the general population.
The finding suggests that public-health efforts to encourage sun protection may be gaining traction, researchers say.
“There seems to be a breakthrough happening that might really reverse the trend for increasing melanoma incidence,” says Margaret Madeleine, an epidemiologist specializing in cancer-incidence trends at the Fred Hutchinson Cancer Research Center in Seattle and co-senior author of the paper in JAMA Dermatology.
Sun protection programs
Ultraviolet radiation from the sun triggers melanoma, the most common skin cancer and fifth most common among all cancers in US men and women. When detected and treated early, patients have a better than 95% chance of surviving five years or more. If not caught early, it can spread to the lungs, brain, or liver, and become highly lethal.
“The vast majority of my practice is older and middle-age adults, but absolutely the skin cancer can affect younger patients,” says Jennifer Gardner, co-senior author of the study and a clinical assistant professor of medicine (dermatology) at the University of Washington School of Medicine.
“I do have patients who are in the prime of their life and otherwise healthy, and they’re thinking about other things and bigger ambitions, and unfortunately this diagnosis really hits them quite hard.”
The researchers gathered de-identified patient data of 988,000 invasive melanoma cases from databases at the Centers for Disease Control and Prevention and the National Cancer Institute. In analyzing data, the investigators calculated annual percentage of change for multiple demographics, including age: pediatric (ages 0-9), adolescent (10-19), young adult (20-29), and adults in 10-year increments from 30 to 80+.
“We were wondering, with the advent of public health programs to increase sun protection—sunscreen and hats and staying in the shade and all the recommendations for skin cancer prevention—if that effort is working. Is there a corresponding decrease we can see reflected in melanoma rates?” Madeleine says.
Sharp fall in teen melanoma
Across all ages, the number of melanoma cases rose steadily during the study span, from 50,272 in 2001 to 83,362 in 2015. The overall increasing incidence rates seen over time was primarily driven by adults 40+ years, the authors write.
However, for adolescents and young adults, incidence peaked around 2005 and then fell sharply through 2015: Among males, the incidence rate dropped about 4% per year and, among females, about 4.5% per year across the two age groups.
The drop-off mirrors reductions in melanoma rates seen among younger populations in Australia starting around 1988, the authors write. They attributed that nation’s turnaround to public-health campaigns for sun-protective behaviors, including a “Slip! Slop! Slap!” campaign.
In the United States, Gardner says, “we’re doing a better job of treating more advanced types of melanoma, but we are still seeing it increasing overall, so the (public health) work is not done. More efforts for prevention make a lot of sense.”
The National Institutes of Health, the Fred Hutchinson Cancer Research Center Integrated Immunotherapy Research Core; and a Society for Immunotherapy of Cancer-Merck fellowship funded the work.
Source: University of Washington