Cancer Resources > Cancer News > 2005 > August

Pediatric melanoma rates continue to rise

Will Boggs, MD

Last Updated: 2005-08-09 10:19:57 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The annual rate of new melanomas in children in the United States is increasing rapidly, according to a report in the July 20th Journal of Clinical Oncology.

"Melanoma is becoming more common in children and adolescents and should be excluded by biopsy if a mole becomes painful, ulcerates, increases in size or bleeds," Dr. John J. Strouse from Johns Hopkins University School of Medicine, Baltimore told Reuters Health.

Dr. Strouse and colleagues used data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database to investigate the incidence of pediatric melanoma from 1973 to 2001, its risk factors, and factors influencing prognosis.

The incidence of melanoma in children increased by 2.9% per year, the authors report. The increases were similar for adolescents and young adults (about 3% per year), but lower for children under 10 years of age (1.4% per year).

Melanoma incidence was higher with increasing age and in females, but significantly lower in blacks, Asians and Native Americans than in whites, the report indicates. The incidence of melanoma directly correlated with environmental UV radiation exposure.

Compared with adolescents and young adults, younger children were more likely to be non-white and more likely to have metastases, nodular or other histology, thicker lesions, a history of cancer, and head, face or neck primary tumors, the researchers note.

Melanoma-specific survival was lower for males than females and lower among patients with regional or distant metastasis, the report indicates. Survival rates did not differ significantly by age.

"With local excision, 5-year survival for pediatric melanoma is excellent, except in the infrequent cases of regional or metastatic disease," the authors conclude. "For these children, effective systemic therapies are needed and are most likely to be identified through close cooperation of national oncology groups to develop trials that include both children and adults."

"No clear screening recommendations exist for children, and screening is unlikely to be worthwhile given the rarity of melanoma in children," Dr. Strouse said. "Timely evaluation of concerning skin lesions is important."

"Pediatric melanoma often presents differently than adult melanoma (more amelanotic lesions) and it can be difficult to distinguish some benign lesions (atypical Spitz nevus) from melanoma, even with a skin biopsy," Dr. Strouse said.

"Prevention by reducing environmental UV exposure is key (sun screen and clothing to block UV, avoidance of hours with peak UV flux, avoidance of indoor tanning)," he added.

J Clin Oncol 2005;23:4735-4741.

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