Pediatric melanoma incidence rates decrease from 2004-2010

Melanoma is an aggressive form of skin cancer that has been increasing in incidence in adults over the past 40 years. Although pediatric melanoma is rare (5-6 children per million), most studies indicate that incidence has been increasing. In a new study scheduled for publication in The Journal of Pediatrics, researchers found that the incidence of pediatric melanoma in the United States actually has decreased from 2004-2010.

Laura B. Campbell, MD, and colleagues from Case Western Reserve University and University Hospitals (UH) Case Medical Center in Cleveland, used data from the Surveillance, Epidemiology, and End Results cancer registries, which represent approximately 28% of the US population, to identify new cases of pediatric melanoma from 2000-2010. According to Dr. Campbell, "We took an in-depth look at whether or not the number of new cases of melanoma per year in children and adolescents was increasing in the recent decade." They also studied how rates changed over time according to age, sex, type of melanoma, and its location on the body.

A total of 1,185 new cases of pediatric melanoma were identified. Overall, the number of new cases each year decreased by 12% per year from 2004-2010. For boys, there was a decrease of almost 7% each year (2000-2010); in 15-19-year-olds, there was a decrease of 11% each year (2003-2010). Additionally, new cases of pediatric melanoma located on the trunk and upper extremities, as well as cases with good prognostic indicators, both decreased significantly each year.

The decreasing trends of new cases of pediatric melanoma directly contrast with significantly increasing melanoma incidence rates reported in US adults across a similar time period, and also contrast with previous reports of long-term increasing incidence trends in the pediatric population.

Reasons that pediatric melanoma incidence rates are decreasing could include effective public health initiatives, a shift to youth participating in more indoor activities, and increased parental awareness to use more sun protective measures with young children. However, as noted by the senior author, Jeremy S. Bordeaux, MD, MPH, a dermatologist at UH Case Medical Center and UH Rainbow Babies and Children's Hospital, "Although it is encouraging to observe decreasing melanoma incidence overall, it is concerning that this decrease is occurring in those cases of melanoma with good prognostic indicators." Therefore, public health programs should continue to teach sun protective behavior (e.g., regular use of sunscreen and protective clothing in the summer, decreased time spent outside, decreased indoor tanning), because limiting exposure to ultraviolet radiation plays a key role in reducing melanoma incidence.