Melanoma Review: Background and Treatment

Eva Berrios-Colon, PharmD, MPH, BCPS; Shalonda Williams, PharmD

Disclosures

US Pharmacist 

In This Article

Incidence Rates and Epidemiology

The incidence of melanoma varies worldwide, with the highest rates in Northern Europe, New Zealand, Australia, and North America.[3] Melanoma has one of the fastest-growing incidence rates in the U.S. The U.S. incidence rate increased from 7.9 to 17.7 per 100,000 persons between 1975 and 2000.[4] The American Cancer Society (ACS) estimates that, in 2012, approximately 76,250 new melanoma cases (44,250 men, 32,00 women) will be diagnosed and about 9,180 individuals (6,060 men, 3,120 women) will die from the disease.[2] Unfortunately, these rates may be underestimated because superficial and in situ melanomas are often managed in outpatient settings, which do not routinely report cases to the cancer registries.[4]

Unlike many other cancers, melanoma affects people of all ages. Incidence increases with age, and people in their 80s have the highest rate of occurrence; however, melanoma is one of the most common cancers in young adults and can occur in those under 30 years of age.[2] Melanoma is rare in children and adolescents; only about 2% of cases are diagnosed in patients younger than 20 years.[3] Overall, the median age of diagnosis is 53 years.[4] Men are affected slightly more than women, with a ratio of 1.3 to 1, but melanoma remains the leading cause of cancer in women aged 20 to 29 years.[1,4] Although mortality rates have declined in younger populations, men aged older than 65 years continue to have the highest mortality rate.[3] Melanoma mortality rates vary from state to state, with the highest rates seen in the northwestern U.S. (FIGURE 1).[5]

Figure 1.

Geographic information system mapping of melanoma mortality rates—National Cancer Institute.

Melanoma is predominantly a malignancy of light-skinned, fair-complexioned people. White populations are most often affected, accounting for 98% of cases.[1,4] People of darker complexion, such as East Asian and Indian individuals, develop melanoma at a rate 10 to 20 times lower than that for white individuals.[1] In the U.S., approximately 1 in 50 (2%) white, 1 in 200 (0.5%) Hispanic, and 1 in 1,000 (0.1%) African American individuals are at risk for developing melanoma in their lifetime.[2]

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