Abstract
7556 Background: Three hundred to 350 new cases of malignant melanoma are diagnosed in children each year in the USA. Risk factors and prognosis in pediatric melanoma are poorly defined. Methods: We analyzed the 1183 pediatric (<20 years of age) and the 34,165 young adult (20–44 years of age) cases of melanoma contained in the 2000 National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Database. We evaluated survival data and risk factors for melanoma development including levels of environmental ultraviolet radiation (UV) based on Environmental Protection Agency (EPA) measurements. Results: Rates of melanoma were lower in blacks (−96%, 95% confidence interval (CI) −98 to −92) compared to whites and males (−30%, 95% CI −38 to −22) compared to females. The incidence risk ratio of melanoma increased 8% (95% CI 7 to 9) per year of age. Melanoma rates varied in different geographic regions, and there was no clear relationship to EPA estimates of UV exposure. Pediatric cases had reported 5-year survival rates of 90.8% (95% CI 88.8 to 92.4). Five-year survival in children was 100% for in situ disease, 94.8% (95% CI 92.8 to 96.3) for localized disease, 69.4% (95% CI 57.6 to 78.5) for regional disease, and 36.1% (95% CI 18.6 to 53.9) for distant disease. The hazard ratio of death for the entire group was increased with older age, male gender, advanced disease, race other than white, second primary, or year of diagnosis before 1990. Conclusions: Factors associated with increased risk of pediatric and young adult melanoma in the SEER registries include Caucasian race, female gender, increasing age, and geographic location at diagnosis. Survival in pediatric patients with melanoma is similar to that seen in young adults. Survival is poor for children and adolescents who present with regional or distant metastases. Effective therapeutic strategies are needed for this group. No significant financial relationships to disclose.
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