Childhood melanoma raises red flag

National report - At least one doctor hopes that recent statistics showing significant increases in childhood melanoma will raise a red flag to both parents and pediatricians.

John Strouse, M.D., a pediatric oncologist and instructor in pediatrics at Johns Hopkins University, co-authored a recent Journal of Clinical Oncology article stating that statistics gleaned from National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) databank show a dramatic rise in the rate of melanoma among children (defined as patients less than 20 years old) and young adults (20 to 24 years old) from 1973 to 2001. Dr. Strouse and his co-authors wrote that the SEER data they evaluated included 1,255 children and 2,673 young adults with melanoma.

"Between the years 1973 and 2001, the incidence of pediatric melanoma increased 2.9 percent per year and 46 percent per year of age," Dr. Strouse tells Dermatology Times.

"I think the value of what we found in these statistics is that they serve as a reminder to parents and doctors alike that melanoma can occur in young children and, more commonly, in older children and young adults," he adds. "I'm not advocating screening for melanoma, but more doctors - especially pediatricians - should be reminded that melanoma occurs in children. It has always been rare in children so they don't tend to have it in the front of their mind as a possibility. I hope these statistics help increase awareness that melanoma in children is a real possibility."

Study findings

Among other findings in Dr. Strouse's and his co-authors' statistical study are the following:

The incidence of pediatric melanoma increased with variables such as white race, female gender, increased age and greater exposure to ultraviolet (UV) radiation

Survival rate at 5 years of age was approximately 94 percent among children diagnosed with melanoma.

Survival was lowest among patients with variables such as male gender, white race, earlier year of diagnosis, older age, more advanced disease, location of the cancer on parts of the body other than the torso or extremities and history of previous cancer.

Data implications

Dr. Strouse says that while no conclusions can be drawn from the statistical evaluation as to the reasons for the increases in pediatric melanoma, it does suggest certain factors.

"Social behavior resulting in more UV exposure has changed since the 1970s," he says. "There may be more sunbathing among young people, and it's very likely that more families travel to hotter climates, even tropical areas, for their vacations in recent years. Perhaps most obvious is the increase in the use of tanning salons, especially among high school girls."

Dr. Strouse says that even in the face of recent studies claiming that vitamin D - which the body acquires most efficiently from the sun's rays - actually helps prevent and treat certain forms of cancer, the statistical analysis suggests that caution should still be used when it comes to sun exposure.

"There is debate over how much sun people should get, and maybe there always will be," he says. "But melanoma can kill, we know it can be caused by the sun's UV rays, and we know that exposure to the sun is one of the only reversible factors available to us in helping prevent melanoma. As much as I like the sun, exposure to UV radiation can be dangerous, and I think our analysis confirms what experts have been suggesting for a long time - that we should be mindful of the sun's dangers and take precautions when we're out in the sun."

Dr. Strouse adds that those precautions include parents limiting their children's exposure to the sun and inspecting their children's skin for changes in moles or freckles.