Abstract
Simple SummaryMelanoma constitutes a major public health risk, with the rates of diagnosis increasing on a yearly basis. Monitoring for risk factors and preventing dangerous behaviors that increase melanoma risk, such as tanning, are important measures for melanoma prevention. Additionally, assessing the effectiveness of various methods to prevent sun exposure and sunburns—which can lead to melanoma—is important to help identify ways to reduce the development of melanoma. We summarize the recent evidence regarding the heritable and behavioral risks underlying melanoma, as well as the current methods used to reduce the risk of developing melanoma and to improve the diagnosis of this disease.(1) Melanoma is the most aggressive dermatologic malignancy, with an estimated 106,110 new cases to be diagnosed in 2021. The annual incidence rates continue to climb, which underscores the critical importance of improving the methods to prevent this disease. The interventions to assist with melanoma prevention vary and typically include measures such as UV avoidance and the use of protective clothing, sunscreen, and other chemopreventive agents. However, the evidence is mixed surrounding the use of these and other interventions. This review discusses the heritable etiologies underlying melanoma development before delving into the data surrounding the preventive methods highlighted above. (2) A comprehensive literature review was performed to identify the clinical trials, observational studies, and meta-analyses pertinent to melanoma prevention and incidence. Online resources were queried to identify epidemiologic and clinical trial information. (3) Evidence exists to support population-wide screening programs, the proper use of sunscreen, and community-targeted measures in the prevention of melanoma. Clinical evidence for the majority of the proposed preventive chemotherapeutics is presently minimal but continues to evolve. (4) Further study of these chemotherapeutics, as well as improvement of techniques in artificial intelligence and imaging techniques for melanoma screening, is warranted for continued improvement of melanoma prevention.
Highlights
Skin cancer is the most common cancer type in the United States (U.S.), estimated to affect nearly one in five individuals over their lifetime [1]
The effective prevention of melanoma is critical to the continued decline in melanoma mortality in the United States, and a multifaceted approach is indicated
Similar interventions have been associated with tanning behavior reduction, as seen in Australia following the implementation of the effective SunSmart awareness campaign
Summary
Skin cancer is the most common cancer type in the United States (U.S.), estimated to affect nearly one in five individuals over their lifetime [1]. The most common hereditary melanoma condition is familial atypical multiple mole melanoma (FAMMM) syndrome These patients are at risk for cutaneous melanoma, pancreatic cancer, and neural system tumors, among other malignancies. Criteria for the diagnosis of FAMMM syndrome include a family history of cutaneous melanoma in a firstor second-degree relative; >50 total nevi with multiple atypical nevi; and specific concerning histologic features in nevi, such as asymmetry, subepidermal fibroplasia, and lentiginous melanocytic hyperplasia with spindle or epithelioid melanocytes, among others [7] This syndrome is most commonly associated with a mutation in the CDKN2A gene, though it has rarely been described with CDK4 mutations. Mutations in BAP1 are associated with cutaneous melanoma, uveal melanoma, and other internal malignancies such as mesothelioma and renal cell carcinoma [9] These patients present with multiple, distinct melanocytic lesions that typically appear after the first few decades of life and usually vary between 5 and 50 in number. For detailed descriptions of the molecular roles of TERT, POT1, PTEN, and MITF, we encourage readers to consult the recent reviews aimed at exploring the function and disfunction of each gene [15–18]
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