A study recently published in the Mayo Clinic Proceedings is suggesting that the overall incidence of skin cancer is dramatically increasing among middle-aged adults (between the ages of 40 to 60). Researchers found that among white, non-Hispanic adults in this age group, the incidence of skin cancer increased 4.5-fold among men and 24-fold among women from 1970 to 2009.1
Using the Rochester Epidemiology Project resource, the investigators identified 383 middle-aged adults who had a first lifetime diagnosis of melanoma between January 1, 1970 and December 31, 2009. All of the patients lived in Olmsted County, Minnesota (population of 144,000 in 2010) and their incidence of melanoma and overall survival and disease-specific survival rates were analyzed based on age, sex, year of diagnosis, and stage of disease.
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Findings from the study demonstrated that age-adjusted and sex-adjusted incidence increased significantly from 7.9 to 60.0 per 100,000 person-years during the study period. Interestingly, the steepest increase in melanoma occurred in the last decade (2000 to 2009). “If you put the pieces together, you see [melanoma incidence increased] in women and we think it due to the popularity of tanning beds. Women make up 71% of the customers who go to tanning beds, and 1 million people go to a tanning bed every day in the United States. So we think that is one of the primary culprits,” said principal investigator Jerry Brewer, MD, an associate professor of dermatology at the Mayo Clinic, in Rochester, MN. “Our thought process is that the big punch from tanning beds is 20 to 30 years later, and so the habits of the 1980s are catching up with them.”
This study adds to the growing body of scientific evidence that the popularization of tanning beds in the 1980s and 1990s may now be resulting in this explosion in melanoma incidence among female middle-aged adults. There were an estimated 76,690 new cases of invasive melanoma in the United States in 2013 and 9,480 deaths as a result of the disease.2
“Right now there is an epidemic of melanoma, and for oncologists it just means that a good chunk of their practice is going to be dealing with [the disease],” Dr. Brewer said in an interview with ChemotherapyAdvisor.com. “The rise in melanoma is astronomical for middle-aged women, but the bottom line is that every melanoma is curable if it is caught early enough.”
Dr. Brewer and his team found that no patient with malignant melanoma in situ died from the disease, and patients with stage 2, 3, or 4 disease were more than 14 times more likely to die from melanoma than patients with stage 0 or stage 1 disease. Another significant finding was that the overall chance of surviving melanoma increased by 7% each year of the study period. Dr. Brewer said the improved survival rates may be due to improved public awareness, better screening, and improved detection of skin cancer at earlier stages.
“This study does support the idea that tanning salons are playing a role,” said David Prelutsky, MD, assistant professor of medicine at Washington University School of Medicine, St. Louis, MO. “I always tell my patients—‘no tanning’—and warn them about tanning salons. I tell them that tanning makes them look older and that usually gets them.” He said greater education efforts are needed to change the widespread misconception that having a tan is associated with being fit and successful.
References
- Lowe GC, Saavedra A, Reed KB, et al. Increasing incidence of melanoma among middle-aged adults: an epidemiologic study in Olmsted County, Minnesota. Mayo Clin Proc. 2014;89(1):52-59.
- American Cancer Society. Cancer Facts and Figures 2013. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036845.pdf. Accessed March 27, 2014.
