Epidemiological, clinical and histological characteristics of melanoma in young adults: a 30-year retrospective study (1993-2022).

Abstract

Melanoma in young adults significantly impacts the survival of this age group. There are limited studies that analyze melanoma characteristics in young patients. We aimed to describe the epidemiological, clinical, and histological characteristics of melanoma in young adults and their temporal trends over the last decades. A retrospective observational study was conducted, involving 399 melanoma patients aged 18-44, over a 30-year period (1993-2022). Patients were divided into two groups based on their date of diagnosis (period 1, 1993-2007, and period 2, 2008-2022). Age at diagnosis was higher in the most recent period (34.3 vs 37; p=0.001). Over time, there was a reduction in thickness (1 vs 0.68 mm; p=0.01), a rise in melanomas located on the head and neck (6.5% vs 14.8%) and extremities (42.2% vs 45%), along with a decrease on the trunk (51.3% vs 40.2%) (p=0.009); and an increase in lentigo maligna (2.3% vs 5.3%) and superficial spreading melanomas (76.5% vs 84%), along with reduction in nodular types (16.1% vs 5.9%) (p=0.012). Women had, compared to men, higher limb melanoma prevalence (56.3% vs 27.1%; p<0.001), family history (11.7% vs 5.1%; p=0.020), lower thickness (0.69 vs 1.10; p= 0.001) and better prognosis (14.4% vs 20.9% deaths; p=0.012). Melanoma diagnoses in young adults occur at progressively advanced ages, with a rise in melanomas situated on the head and extremities and in histological types linked to prolonged sun exposure. Strategies like minimizing sun exposure from a young age and encouraging self-examination could lead to improved survival rates.