Dramatic increase in melanoma incidence among American Youth.
Melanoma has become a major health problem in our society because of our obsession with the "perfect tan". Melanoma was once considered a cancer of adults because it was rarely diagnosed in young people. However, reports that melanoma had increased in children and young adults by 3% a year between 1973 and 2001 made it difficult to ignore this alarming trend (Strouse, 2005). Melanoma may be missed in young patients because the health care provider does not appreciate that young patients are at risk for the disease or that it's clinical presentation may be different than in adults. This lack of understanding or low index of suspicion may prove deadly for some patients.
There will be an estimated 76,380 new cases of melanoma (46,870 in men and 29,510 in women) diagnosed in the United States this year (ACS, Cancer Facts & Figures, 2016). Melanoma has been increasing faster among children living in the northern US, as compared to those living in the South, probably because of the intense, sporadic exposures experienced in northern latitudes (Wong, 2012). Although melanoma is not common among children, 72% of melanoma cases do occur in teenage girls between the ages of 15-19 (Maguire-Eisen, 2013). In addition, melanoma is now the most common cancer diagnosed in white females, ages 20-24, and the fourth most common in young males of the same age (www.seer.cancer.gov/csr/1975_2001). There will be 9,940 deaths from melanoma this year with twice as many men dying of the disaese than women. With one person dying every hour from melanoma, we must all work together to educate the public about this preventable disease and easily recognizable disease.
* SEER Data 1975-2009
Skin cancer is clearly a growing health problem for children because of the persistent reports of sunburns and the rising rates of pediatric melanoma (Maguire-Eisen, 2014). Ultraviolet light was been a proven human carcinogens since 2002. The National Institute of Health reported that exposure to ultraviolet radiation from either sunlight or artificial tanning sources was associated with skin cancer, cancer of the lip and melanoma of the eye. (10th Report on Carcinogens, 2002). Sunburns in childhood, are a known acquired risk factor for melanoma (Tsao et al., 2004). Reports that half of all American children experience one summer sunburn and 12% of adolescents experience at least 5 sunburns is a clear sign of inadequate knowledge (Davis, 2002). In addition, the popularity of indoor tanning is increasing among teenagers with rates of indoor tanning doubling between 14-15 and 15-16 years of age (Geller, 2002).
Melanocytes are pigment producing cells that are genetically programmed to determine skin and eye color. Moles are harmless growths that arise from melanocytes. The tendency to develop moles is inherited however sun exposure may increase the number of moles we acquire or develop during our lifetime (American Academy of Dermatology, 2006). Because half of all melanomas develop in moles it is important to prevent overexposure to UV radiaiton to limit the number of acquired moles. Sunburn prevention is important because it may protect children from acquiring new moles and therefore reduce melanoma risk.
Melanomas are usually pigmented and may include brown, black, blue, or grey pigments. Although, some melanomas lack pigment and appear red or pink. Melanomas in young children may appear as a red bump or pink papule on the skin (amelanotic). The classic ABCDE warning signs of melanoma include Asymmetry, Border irregularity, Color variability, enlarging Diameter or an Evolving growth. However, we recommend that any new or changing growth persisting for more than one month be evaluated by a health care provider.
Anyone can develop melanoma, although the risk is greatest for individuals with light eyes, pale skin, freckles, excessive sun exposure in childhood, a large number of common or atypical moles and a family history of melanoma. Female gender has become a risk factor for developing melanoma in young white Americans. Melanoma is twice as common in young white females aged 20-24 as compared to males of the same age and ethnicity (Strouse, 2005).
Children's Melanoma Prevention Foundation was created to combat the dramatic increase in melanoma among American youth. We have partnered with schools and the community to educate, motivate and reduce skin cancer in our society. Our K-12 SunAWARE Program provides skin cancer prevention lessons to students, parents, nurses and teachers. Our skin cancer workshops are designed to educate nurses about skin cancer prevention and early detection. We use innovative technology to educate children about proper sun protection. We encourage students to identify the factors that effect UV intensity and skin sensitivity. We teach practical lessons on sun protection along with tips for early detection of skin cancer. We encourage children to have fun in the outdoors but to take appropriate precautions to protect their health. Our goal, is to prevent skin cancer one child at a time by teaching them to be SunAWARE!
Maryellen Maguire-Eisen RN, MSN