Among White Adolescents, Young Adults with Melanoma, Males Have Higher Mortality Than Females


Among white adolescents and young adults with melanoma, males have higher mortality than females, according to a report published by JAMA Dermatology, a JAMA Network publication.1

Few studies have explored survival differences by sex in adolescents and young adults, in whom melanoma is the third most common cancer.

“Focusing on sex disparities in survival among younger individuals may provide further evidence of biological rather than behavioral factors that affect melanoma outcome,” according to the study by Christina S. Gamba, M.D., of the Stanford University Medical Center, California, and colleagues.

Researchers sought to determine whether long-term survival varied between white male and female adolescents and young adults with melanoma (ages 15 to 39 years at diagnosis) in the United States.

The study included 26,107 non-Hispanic white adolescents and young adults with a primary invasive melanoma of the skin diagnosed from January 1989 through December 2009. There was an average follow-up of 7.5 years. Researchers identified 1,561 melanoma-specific deaths in the study population.

Adolescent and young adult males accounted for fewer overall melanoma cases (39.8 percent) than females, but they comprised 63.6 percent of the melanoma-specific deaths.

“Adolescent and young adult males were 55 percent more likely to die of melanoma than age-matched females after adjustment for tumor thickness, histologic subtype, presence and extent of metastasis and anatomical location,” according to the results.

Researchers suggest that continued public health efforts are needed to raise awareness of the outcome of melanoma in young men.

“This alarming difference in the outcome highlights the urgent need for both behavioral interventions to promote early detection strategies in young men and further investigation of the biological basis for the sex disparity in melanoma survival,” the study concludes.

In an editorial2, David E. Fisher, M.D., Ph.D., of Harvard Medical School, Boston, and Alan C. Geller, M.P.H., R.N., of the Harvard School of Public Health, Boston, write: “Although men fare worse than women for melanoma detected at less than 1 mm, overall survival is far greater for individuals diagnosed with thin melanomas compared with those with melanomas that are at least 1 mm deep. Young men are far less likely than young women to see primary care physicians trained to provide preventive screenings and counseling. Discovering earliest-stage melanoma in young men will have its challenges.”

“However, a 3-fold strategy of awareness raising, more opportunities for screening and incentives to screen should be implemented,” they continue.

“Hopefully, studies such as the one reported herein can prompt primary care physicians of young at-risk men to carefully screen their patients and counsel them to perform monthly skin self-examinations,” they conclude.

References:

1. JAMA Dermatol. Published June 26, 2013. doi:10.1001/jamadermatol.2013.4408.

2. JAMA Dermatol. Published June 26, 2013. doi:10.1001/jamadermatol.2013.4437