The incidence of head and neck melanoma among young people in Canada and the U.S. increased 51.1% between 1995 and 2014, according to new research published in JAMA Otolaryngology-Head and Neck Surgery (Oct. 3, 2019, online ahead of print).
This research project was motivated by two factors, study author Nosayaba Osazuwa-Peters, PhD, said in a press release. Dr. Osazuwa-Peters, from St. Louis University’s department of otolaryngology in St. Louis, said the factors were the lower survival rates of melanomas occurring on the head and neck, and the higher exposure to melanoma risk factors—particularly sun exposure and indoor tanning—among young people.
Data on head and neck melanoma obtained from the North American Association of Central Cancer Registries’ Cancer in North America public use data set from 1995 to 2014 was used for the study. At the time of the study’s publication, this data set included 93% of the U.S. and 64% of the Canadian populations.
From that database, 12,462 patients aged 0 to 39 years with a confirmed diagnosis of melanoma in primary head and neck sites were included.
The authors found that the most frequent sites where these melanomas were diagnosed were the skin of the neck and scalp. The lips were the least likely site for melanoma to be diagnosed.
In the U.S., the incidence increased 4.68% yearly from 1995 to 2000 and 1.15% yearly from 2000 to 2014. In Canada, the incidence increased 2.18% yearly from 1995 to 2014.
“This is the first study of head and neck melanoma in adolescents and young adults in the United States and Canada combined,” Dr. Osazuwa-Peters said.
“While we found a 51 per cent increase in incidence during the last two decades in our study, another important finding is that incidence was greater among males than females, especially among white males.”
In the United States, non-Hispanic white patients had the highest age-adjusted incident rates (AAIR) of melanoma, while non-Hispanic black or other race patients had the lowest AAIR.
“This is an important finding because melanoma in other parts of the body are usually more common in females than males,” said Dr. Osazawa-Peters. “It is therefore important that melanoma prevention campaigns do not only focus on young women.”
The authors note that because they were working from retrospective data, they are unable to make causal inferences. As well, the Canadian data lacked racial or ethnic identifiers, so they could not draw any racial or ethnic information from it.
“There is room for the lay public to help in early detection,” Dr. Osazuwa-Peters said. “For example, barbers and stylists might be the first to spot irregular skin on the scalp before the doctors do. It is therefore important to increase awareness about this cancer. This is in support of the ABCDE campaign that was initiated by experts over 30 years ago, which had the goal of increasing the lay public’s recognition of early signs of melanoma.”
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