Malignant Melanoma Death Rates Rise in White Americans

NEW YORK (Reuters Health) - Using sunscreen to cut down exposure to the harmful rays of the sun is as important as ever, according to a study demonstrating that deaths from malignant melanoma skin cancer are on the rise in white Americans. Although figures from the 1990s suggest that the rate has stabilized in women, it is climbing in men.

Some reasons cited by the study's authors explaining this difference lie in the different levels of knowledge and awareness of skin cancer between men and women. Previous research has shown that while 39% of women are aware of the need for self-examination to detect skin cancer, only 29% of men are.

Women may also be more likely to get screened, protect themselves from the sun and have thin, localized skin cancers, which are more curable than thick, advanced cancers that are often found in men.

Dr. Ahmedin Jemal and his colleagues at the Division of Cancer Epidemiology and Genetics of the National Cancer Institute in Bethesda, Maryland, looked at changing patterns in the incidence and death rates of cutaneous malignant melanoma, one of the most serious forms of skin cancer. Their goal was to determine how changing levels of ultraviolet (UV-B) radiation from the sun and Americans' North-South migration affected the risk of skin cancer cases and deaths.

The study analyzed data collected in the 1950s through 1980s and the years 1990-1995 from a centrally located national cancer registry. Similar to national statistics, the death rate for melanoma in four areas (Atlanta, Georgia; Connecticut; Detroit, Michigan; and San Francisco-Oakland) rose significantly from 1950-1954 through 1990-1994--191% in men and 84% in women.

In an interview with Reuters Health, Jemal said that the team looked for the relationship between extra risk of melanoma death rates and incremental increases (10%) in UV-B rays within the time periods studied.

The investigators found that there was a direct relationship between the two factors, and that until 1950-1969, the risk increased more in northern areas than in the South. This suggests that northerners were increasing their risk by travelling to the South and extending their time in the sun and exposing themselves more to UV-B radiation. Today, the rates are more uniform across geographic regions.

``Melanoma mortality in the United States reflects the complex interplay of UV radiation levels in each geographic region, the sun-protection behaviors of each generation of males and females in childhood and adulthood, the geographic mobility of the population, and the risk awareness and early detection,'' the researchers conclude.

SOURCE: Journal of the National Cancer Institute 2000;92:811-818.