Original article
Increasing Incidence of Melanoma Among Young Adults: An Epidemiological Study in Olmsted County, Minnesota

https://doi.org/10.1016/j.mayocp.2012.01.010Get rights and content

Abstract

Objective

To identify the change in the incidence of cutaneous melanoma over time among young adults.

Patients and Methods

Using Rochester Epidemiology Project data, we identified patients aged 18 to 39 years who had a first lifetime diagnosis of melanoma from January 1, 1970, through December 31, 2009, in Olmsted County, Minnesota. Demographic and clinical information, including survival, was abstracted, and estimates of the incidence of melanoma and overall and disease-specific survival were generated.

Results

From 1970 to 2009, the incidence of melanoma increased by 8-fold among young women and 4-fold among young men. Overall and disease-specific survival seemed to improve over time; hazard ratios comparing year of diagnosis with mortality were 0.92 and 0.91, respectively.

Conclusion

The incidence of cutaneous melanoma among young adults is rapidly increasing, especially among women. Continued close monitoring of this high-risk population is necessary.

Section snippets

Patients and Methods

The Rochester Epidemiology Project (REP) was started in 1966, when indexes of diagnoses were created for use by the medical professionals in Olmsted County, Minnesota. The result is linkage of medical data from almost all sources of medical care available to the local population of the county. This data resource provides the ability to conduct population-based analytic studies for almost any disease.13

This study was approved by the institutional review boards of Olmsted Medical Center and Mayo

Results

Using REP resources, we identified 256 young adults between the ages of 18 and 39 years who were residents of Olmsted County, Minnesota, at their first lifetime diagnosis of melanoma between 1970 and 2009. Characteristics of the 256 young adults under study are summarized in Table 1.

Histologic slides were available for 220 of the 256 melanomas. On the basis of reanalysis, the diagnosis of melanoma was confirmed for all tumors. The histologic subtype was changed from unknown to a known category

Discussion

Our study confirms that the incidence of cutaneous melanoma is increasing among young adults, with this incidence increasing more than 6-fold during the past 40 years in these patients. The lifetime risk of melanoma is higher in males than females, although the opposite is true in young adults and adolescents, with the female-male incidence ratio being as high as 1.8 in young adults aged 20 to 24 years.4 The present study confirms this trend, but we observed that the rate of increase of the

Conclusion

This study demonstrates an increase in the incidence of melanoma among young adults in Olmsted County, Minnesota, with young women being at higher risk than young men. Although the incidence is increasing, the mortality from this disease seems to be decreasing. Our results emphasize the importance of active interventions to decrease risk factors associated with melanoma in young individuals. In addition, skin cancer screening examinations in young adults are strongly recommended.

Acknowledgments

Christine M. Lohse, MS, performed the statistical analyses.

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    Grant Support: A portion of this work was supported in party by National Institutes of Health grant and the Rochester Epidemiology Project (grant number R01-AG034676; Principal Investigator: Walter A. Rocca, MD, MPH). Dr Brewer is a recipient of a Dermatology Foundation Career Development Award for the study of lymphoma-associated skin cancer.

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