In the Journals

Death from melanoma likely to become 'rare event' in light-skinned populations

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March 19, 2015

Death from melanoma over the next several decades should stabilize and then decline in light-skinned populations, according to study results.

This reduction in melanoma mortality — which may be more apparent in younger generations — may be linked to UV exposure patterns, researchers wrote.

“Independent from screening or treatment, over next decades, death from melanoma is likely to become an increasingly rare event,” Philippe Autier, MD, director of the International Prevention Research Center in Lyon, France, and colleagues wrote. “The temporary epidemic of fatal melanoma was most probably due to excess UV exposure of children that prevailed in 1900 to 1960, and mortality decreases would be due to progressive reductions in UV exposure of children over the last decades.”

Autier and colleagues evaluated data from the WHO mortality database in order to evaluate time changes in cutaneous melanoma mortality in light-skinned populations. The analysis included data from different regions in Oceania, North America and Europe.

Researchers found that lifetime mortality risk for melanoma increased successively from 1875 in each region. The mortality rate peaked first in Oceania (birth years 1936-1940) and last in Central Europe (birth year 1957). Peak years for melanoma death tended to be similar among men and women within each region.

Southern Europe is the only region for which peak lifetime risk for melanoma mortality has not yet been observed, researchers wrote.

The lifetime risk for melanoma mortality decreased among generations born following these peak years. Individuals born between 1990 and 1995 demonstrate a risk for melanoma mortality that was comparable to that of individuals born between 1900 and 1905.

The decreased risk for melanoma mortality according to birth year suggests the risk will persist in older generations, according to researchers.

Melanoma mortality rates from 2005 to 2010 among men in Northern Europe exemplify this difference. Ten percent of melanoma deaths in this population occurred among those aged younger than 50 years; 40% occurred in those aged 50 to 69 years; and 50% occurred in those aged older than 69 years. However, from 1955 to 1959, melanoma mortality did not increase with age. The rate for melanoma death was 30% in individuals aged younger than 50 years, as well as those aged older than 69 years.

“If dying from melanoma is deemed to become a steadily uncommon event in younger and middle-aged adults, population aging will keep numbers of patients diagnosed with potentially fatal melanoma at a high level over the next 2 decades because the risk of melanoma death in men and women born around 1940 to 1950 is still high,” Autier and colleagues wrote. “After 2030, numbers of melanoma deaths are likely to progressively vanish when subjects born from 1970 onward who have a low risk of melanoma death will reach their sixth or seventh decade of life.”

Because melanoma mortality was associated with cohort effects rather than period effects, the changes in mortality risk may not be related to screening and treatment, the researchers wrote.

“We [hypothesize] that trends in melanoma mortality would be due to dramatic changes in exposure of small children to UV radiation, when in the second part of the 19th century, beliefs in the healthiness virtues of the sun and of UV radiation expanded among health professionals and large segments of the population,” Autier and colleagues wrote. “The strong association between aging and the risk of melanoma death suggests an interplay between accumulated sun exposure and the age-related decreasing capability of the immune system to control dormant cancer cells having considerable malignant potential.” – by Cameron Kelsall

Disclosure: The researchers report no relevant financial disclosures.

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