Survival outcomes of advanced melanoma are worse for adolescents and young adults (AYAs) than for older adults, according to a population-based study published in the Journal of the American Academy of Dermatology.

Data for this study were sourced from 81,597 patients in the California Cancer Registry with cutaneous melanoma diagnosed between 2004 and 2015 and evaluated for survival through 2017. Risk factors for mortality were evaluated on the basis of age.

The cohort included 12,505 AYAs (aged 15 to 39 years) and 69,092 older adults (aged 40 to 64 years). AYAs were more likely than older adults to be female (62.6% vs 44.5%). In both age groups, most patients were White (75.9% of AYAs and 82.5% of older adults).

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Compared with older adults, the AYAs developed in situ melanoma (P <.001) or ulceration (P =.03) less frequently, but AYAs were more likely to have tumors with mitotic activity (P <.001).

All-cause deaths occurred in 599 AYAs and 5824 older patients. Melanoma-specific deaths occurred in 459 AYAs and 3023 older patients.

With stage I disease as the reference, the mortality risk was higher in AYAs than in older adults with stage IV disease (adjusted hazard ratio [aHR], 20.39 vs 10.79), stage III disease (aHR, 3.31 vs 3.18), and stage II disease (aHR, 2.08 vs 1.53).

“Survival was much worse for AYAs with stage IV melanoma than observed among older adults,” the researchers wrote. “To improve AYA survival, early melanoma detection is critical. Greater awareness, suspicion, and screening for AYA melanoma may disrupt delays in diagnosis and reduce the excess burden of mortality from stage IV melanoma in young patients.”


Wojcik KY, Hawkins M, Anderson-Mellies A, et al. Melanoma survival by age group: population-based disparities for adolescent and young adult patients by stage, tumor thickness, and insurance type. J Am Acad Dermatol. Published online January 4, 2023. doi:10.1016/j.jaad.2022.10.063

This article originally appeared on Oncology Nurse Advisor