Increased diagnosis of thin superficial spreading melanomas: A 20-year study

Frangos, Jason E.; Duncan, Lyn M.; Piris, Adriano; Nazarian, Rosalynn M.; Mihm, Martín C.; Hoang, Mai P.; Gleason, Briana C.; Flotte, Thomas J.; Byers, H. Randolph; Barnhill, Raymond L.; Kimball, Alexa B.

doi:10.1016/j.jaad.2011.10.026

Cited by 69 publications

(60 citation statements)

References 38 publications

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“…Statistics are presented for registries with at least 10 years of data and with annual incidence rates !1/100,000 person-years. coding or registration practices may have perhaps contributed less to the reported increases 49 than an increasing awareness of skin cancer among health professionals 50 and the general public. Incidence rates are still uniformly increasing in most European countries, including almost all Southern and Eastern European countries studied.…”

Section: Discussionmentioning

confidence: 99%

International trends in the incidence of malignant melanoma 1953–2008—are recent generations at higher or lower risk?

Erdmann

Lortet‐Tieulent

Schüz

et al. 2012

Intl Journal of Cancer

540

444

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The incidence of cutaneous malignant melanoma has steadily increased over the past 50 years in predominately fair‐skinned populations. This increase is reported to have leveled off recently in several Northern and Western European countries, Australia, New Zealand and in North America. We studied the global patterns and time trends in incidence of melanoma by country and sex, with a focus on and age‐ and cohort‐specific variations. We analyzed the incidence data from 39 population‐based cancer registries, examining all‐ages and age‐truncated standardized incidence rates of melanoma, estimating the annual percentage change and incidence rate ratios from age‐period‐cohort models. Incidence rates of melanoma continue to rise in most European countries (primarily Southern and Eastern Europe), whereas in Australia, New Zealand, the U.S., Canada, Israel and Norway, rates have become rather stable in recent years. Indications of a stabilization or decreasing trend were observed mainly in the youngest age group (25–44 years). Rates have been rising steadily in generations born up to the end of the 1940s, followed by a stabilization or decline in rates for more recently born cohorts in Australia, New Zealand, the U.S., Canada and Norway. In addition to the birth cohort effect, there was a suggestion of a period‐related influence on melanoma trends in certain populations. Although our findings provide support that primary and secondary prevention can halt and reverse the observed increasing burden of melanoma, they also indicate that those prevention measures require further endorsement in many countries.

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Section: Discussionmentioning

confidence: 99%

International trends in the incidence of malignant melanoma 1953–2008—are recent generations at higher or lower risk?

Erdmann

Lortet‐Tieulent

Schüz

et al. 2012

Intl Journal of Cancer

540

444

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“…2 It is well established that there has been a significant increase in the number of thin melanomas (<1.0 mm in thickness), which may be attributed to increased skin cancer awareness and skin cancer screening in many Western countries. 3,4 As a result, melanocytic lesions are increasingly being sampled or removed at an early stage. Although the vast majority have a favorable outcome, the American Joint Committee on Cancer (AJCC) has emphasized the variability (85% to 99%) of 10-year survival for thin melanoma, 5 and estimates suggest that up to 20% of thin melanomas can be associated with metastasis, among which 5% are fatal.…”

Section: Introductionmentioning

confidence: 99%

Using global gene expression to discriminate thin melanomas with poor outcomes

Hothem

Bayci

Thibodeau

et al. 2016

Molecular & Cellular Oncology

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Most melanomas present as thin lesions (1.0 mm) with a good prognosis; however, a small percentage of patients with thin lesions experience recurrence or metastasis. The aim of our study was to identify a distinct pattern of gene expression within thin melanomas known to have eventually metastasized to regional lymph nodes or distant sites compared with those that followed the typical course with good response to wide local excision alone. Patients who were disease-free for a minimum of 10 y served as controls (n D 10) to the experimental group who developed metastasis (n D 9). Laser capture microdissection was used to specifically isolate cancer cells from formalin-fixed paraffin-embedded tissue with subsequent gene expression analysis on Affymetrix Human Transcriptome Array 2.0 Arrays. Although gene expression differences were observed between the patients with thin melanoma with poor clinical outcome and those with good clinical outcome, neither the number of genes nor the magnitude of the fold difference was very substantial or significant. Cluster analysis with this subset of genes could definitively separate a subset of the poor responders from the good responders, but there remained a mixed group of tumors that could not be predicted from gene expression alone. Pathway analysis identified cellular processes that were regulated based on the response, including categories commonly associated with melanoma progression. Ultimately, we concluded that there were very few differences between these groups. Future research will be required and investigation of the mutational landscape may be another strategy to uncover genomic changes that drive recurrence and metastasis in thin melanoma.

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“…Diagnoses rendered in 1988 to 1990 resulted in a mean number of 11 melanomas; diagnoses of the same slides rendered in 2008 to 2009 resulted in a mean number of 18 melanomas. 24 These studies did not address MIS specifically, which makes it difficult to interpret whether the incidence of MIS is truly increasing or whether it is a reflection of increased diagnostic scrutiny (ie, more vigilant biopsy and screening efforts and more aggressive interpretation by dermatopathologists). 11 The mean time to diagnosis of a second tumor of any type was 14 years.…”

Section: Incidence Key Pointsmentioning

confidence: 99%