Malignant melanoma is not common in children, accounting for about 3% of all childhood cancers. Unfortunately, the rate of pediatric melanoma cases has been rising — about 2% per year over the last 40 years. Denise Mann sheds some light:
Recent studies have also shown that melanoma is on the rise among adults as well. Exactly what is driving these trends is not fully understood, but increased exposure to ultraviolet radiation from both the sun and tanning booths as well as greater awareness of melanoma may be responsible, according to study authors led by Jeannette Wong of the U.S. National Cancer Institute.
The researchers used a database to capture trends in childhood melanoma, but they did not have any information on participants’ tanning habits or sun exposure history.
Boys were more likely to develop melanomas on their face and trunks, while girls were more likely to have melanoma on their lower legs and hips, the investigators found. Other risks for melanoma among children and adults include fair skin, light-colored hair and eyes, moles, family history of melanoma and a history of sunburns.
A new report in Pediatrics focuses on the dangers of indoor tanning beds. This may be why the biggest increase in melanoma rates have been in adolescent white girls:
Indoor tanning is practiced by as many as 35% to 40% of white adolescent girls. It is estimated that 25% of melanomas observed in young women might be attributable to using tanning beds. It therefore stands to reason that pediatricians have an obligation to discuss this potentially life-threatening practice with families. Although pediatricians are often considered trusted advisors to families, sometimes over years and decades, many do not take opportunities to discuss indoor tanning.
I know I could do a better job counseling teenagers about the dangers of the sun AND tanning beds. But Karen Kaplan says the message may not be getting through:
You would think that people who were diagnosed with melanoma — the most deadly form of skin cancer — would be meticulously careful about using sunscreen, avoiding tanning salons and generally protecting their skin.
You would be wrong, researchers said Monday.
Most melanoma survivors learn to avoid the sun and stop using tanning beds, but the lesson is not learned universally:
The biggest risk factor for melanoma is exposure to UV rays, either from sunlight or artificial sources such as tanning lamps. Patients who have been treated for melanoma should know this better than anyone.
And yet, 27.3% of melanoma survivors who answered the 2010 National Health Interview Survey said they never wore sunscreen. Never.
Kaplan has more:
In addition, 15.4% of former melanoma patients said they rarely or never stayed in the shade and 2.1% had been to a tanning salon in the previous year.
Sanjay Gupta, MD has the last word:
Despite a vastly increased risk of recurrence, many melanoma survivors continue to engage in risky behaviors. In addition to the countless educational campaigns aimed at combating the problem, what else should we as clinicians be doing?
California and Vermont have both banned indoor tanning for people under 18 years of age. We ban the sale of tobacco to minors. Perhaps we should ban the sale of artificial ultraviolet light to kids as well.
(Image: NK — St. Thomas Sunburst)