Abstract
In order to explore melanoma risk factors through gender-, age-, race-, and site-specific incidence rates, malignant melanoma cases from the Caucasian whites and non-whites were retrieved from the US SEER database. Age-standardized, age-, and site-specific tumor rates were calculated. All races and both genders showed positive annual average percentage changes (AAPCs) over the years, but AAPCs varied at different body sites, with men’s trunk exhibiting the fastest increase. Non-whites were diagnosed at a significantly younger age than whites and showed a trend towards fewer gender differences in the age of diagnosis. However, non-whites and whites showed a similar pattern of age-specific gender differences in the incidence rate ratios. A consistent spiked difference (female vs. male, incidence rate ratio (IRR) >2) was observed at or near the age of 20–24 in all race groups and at all body sites. The highest female vs. male IRR was found in the hip and lower extremities, and the lowest IRR was found in the head and neck region in all races. These race-, gender-, and site-dependent differences suggest that age-associated cumulative sun exposure weighs significantly more in late-onset melanomas, while genetics and/or pathophysiological factors make important contributions to early-onset melanomas.
Highlights
Malignant cutaneous melanoma (CM) is the number one cause of death in skin cancer patients in the US [1], and the incidence rate has continued to increase since the 1930s [2]
While the mean age of diagnosis for all sites did not show a significant gender difference in the white population (p = 0.18, two-sample t-test), the mean diagnosis ages in the Head/Neck, Trunk, and Lower areas were significantly different between white men and white women
Thegender most differences in melanoma incidence rates were in the head and neck region and notable gender differences in melanoma incidence rates were in the head and neck region
Summary
Malignant cutaneous melanoma (CM) is the number one cause of death in skin cancer patients in the US [1], and the incidence rate has continued to increase since the 1930s [2]. The risk factors have not been completely elucidated, but a pathophysiological role of sex has been suggested in addition to UV radiation [3,4,5]. The sex differences in body site distribution of CM incidence rates have contributed to this assumption [6,7,8,9]. Men have tumors predominantly on the trunk, especially on the back [10], while women have more tumors on the lower extremities [10]. CMs in the head and neck area are rising in men, with subtle distinctions identified between sexes on the face [11]. UV radiation has long been considered the primary environmental risk factor for CM
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