Early Detection of Thick Melanomas in the United States

Demierre, Marie‐France; Chung, Connie; Miller, Donald R.; Geller, Alan C.

doi:10.1001/archderm.141.6.745

Cited by 128 publications

(123 citation statements)

References 37 publications

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“…As in previous studies, males were more likely to have late-stage disease. 24 Similar to prior analyses, nodular melanomas were more likely to be later-stage than melanoma of unclassified histology, 25 while superficial spreading and lentigo maligna melanomas were less likely to be late-stage. However, nearly 50% of melanoma subtypes were not specified, which limits the interpretation of this finding.…”

Section: Discussionsupporting

confidence: 56%

California Medicaid Enrollment and Melanoma Stage at Diagnosis

Pollitt

Clarke

Shema

et al. 2008

American Journal of Preventive Medicine

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Section: Discussionsupporting

confidence: 56%

California Medicaid Enrollment and Melanoma Stage at Diagnosis

Pollitt

Clarke

Shema

et al. 2008

American Journal of Preventive Medicine

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“…Investigations aiming to clarify early features of melanoma in the elderly and promotion of these features to the population and to primary care practitioners would be valuable in secondary prevention of melanoma in the older ages. 2,21 Other explanations for the late diagnosis in elderly individuals is deteriorating vision, loss of partner, development or increase of seborrheic keratoses, with which melanoma can be easily confused, small nevi density, which leads to lower consciousness of melanoma risk, and development of a higher proportion of melanomas in hard-to-see anatomic sites (ie, back). 22 Unfortunately, data regarding the presence of pigmented lesions other than melanoma were not available for analysis in our study.…”

Section: Discussionmentioning

confidence: 99%

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

Lasithiotakis¹,

Leiter²,

Meier³

et al. 2008

Cancer

227

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BACKGROUNDThe aim was to identify age‐ related and gender‐related differences in the clinical presentation and outcome of patients with primary cutaneous melanoma (CM).METHODSA total of 4785 CM patients without clinical evidence of metastasis diagnosed during the period 1976–2001 in southern Germany included in the analysis. Kaplan‐Meier analyses were performed to estimate and to compare disease‐specific survival (DSS) and survival after first recurrence (SAR). The Cox proportional hazards model was used to evaluate the effect of multiple variables on DSS and SAR.RESULTSIncreasing age and male gender were independently associated with thicker tumors (>2 mm) and histologic ulceration (P < .001). Patients older than 65 years had lower 10‐year DSS than younger patients (81.8% vs 88.4%, P < .001) and this difference was more pronounced in women (P < .001) than in men (P = .06). Males had lower 10‐year DSS than females (83.5% vs 88.5%, P < .001) but this difference did not reach statistical significance in patients older than 65 years (P = .162). In multivariate analysis adjusted for tumor thickness, ulceration, anatomic site, histologic subtype, DSS, site of first recurrence, time trend, sentinel lymph node status, age, and gender were independent predictors of DSS and SAR (P < .05).CONCLUSIONSOlder age and male gender are associated with prognostically unfavorable primary CM. Expansion of current preventive strategies to target these subgroups is warranted. Moreover, age and gender are independent predictors of the outcome of CM patients. Females have a better prognosis than males but this difference disappears after the age of 65. Younger patients have a more favorable prognosis than older patients, a difference more pronounced in women. Cancer 2008. © 2008 American Cancer Society.

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“…Over the 25-year period, nodular melanomas have increased significantly only in males and females aged over 60 years. This should be borne in mind in early detection campaigns as nodular melanomas tend to be thicker than other subtypes, and current public education concentrates mainly on the less aggressive superficial spreading type (Demierre et al, 2005). Lentigo maligna melanoma has increased in those aged 60 years and over, with the steepest rise from 1994 -1998 to 1999 -2003. This trend suggests an effect of total cumulative lifetime UV exposure, which is believed to be of greater aetiological importance for lentigo maligna melanoma than for other histological variants.…”

Section: Histopathological Subtypementioning

confidence: 99%

Melanoma incidence and mortality in Scotland 1979–2003

et al. 2007

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We studied 12 450 cases of invasive melanoma diagnosed in Scotland in 1979Scotland in -2003, by thickness, pathological type, and body site at ages under 40, 40 -59, and 60 years and over. Melanoma incidence trebled in males from 3.57 to 10.93/10 5 per year, and increased 2.3-fold in females from 5.60 to 12.96/10 5 per year. The rate of increase fell in each successive 5-year period. The greatest increase was in males aged 60 years and over at diagnosis. Significant incidence increases were seen in melanomas o1 mm in all three age groups, but those 44 mm only increased significantly at ages 60 years and over. All histological types increased significantly at ages 60 years and over, and in this age group the greatest increase was seen on the head and neck. Five-year disease-free survival improved steadily. Survival figures for 1994 -1998 ranged from 93.6% for males and 95.8% for females with tumours o1 mm, to 52.4 and 48.3%, respectively, for those with tumours 44 mm. Over the 25 years, melanoma mortality doubled in males from 1.1 to 2.4/10 5 per year, but was unchanged in females at 1.5/10 5 per year. Public education on melanoma is required both for primary prevention and earlier diagnosis, particularly for older males.

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Early Detection of Thick Melanomas in the United States

Cited by 128 publications

References 37 publications

California Medicaid Enrollment and Melanoma Stage at Diagnosis

California Medicaid Enrollment and Melanoma Stage at Diagnosis

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

Melanoma incidence and mortality in Scotland 1979–2003

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