Melanoma Cases on the Rise
Researcher Says Increase in Melanoma Cases Isn't Just Due to Better Screening
Is Rise in Melanoma Due to a Change in How Melanoma Is Diagnosed?
In a large international study, pathologists reviewed 2,665 pigmented lesions that had been originally been analyzed by pathologists from the 1930s to the 1980s. Their diagnoses matched, Rigel says.
Is Rise in Melanoma Due to Better Ways of Counting Cancer Cases?
The National Cancer Institute's method of counting cancer primarily relies on reports from hospitals about how many cancers are being seen in their institution each year, he says.
"So if we were better at counting cancer, you would expect rates of all cancers to go up, which is not the case," Rigel says.
In fact, melanoma is probably underreported, he says, as it is the only major cancer where patients are not seen in the hospital during the course of their disease.
"I often diagnose a patient in my office and excise the skin lesion in the office so the patient never even makes it to the hospital," he says.
A 1991 study, published in the Journal of the American Academy of Dermatology, showed that up to 19% of cases in Massachusetts were never reported. A 1997 study in the same journal showed a17% rate of underreporting in Iowa, Rigel adds.
Melanoma: Deaths vs. Survivals
Additional evidence for a real rise in melanoma cases comes from the fact that deaths from skin cancer are also on the rise, Rigel says. Yet at the same time, a patient's chance of surviving for at least five years from diagnosis is also on the rise.
If more people are dying of melanoma and more people are surviving melanoma, the only mathematical option is that cases are going up faster, he says.
Melanoma: Don't Become a Statistic
The bottom line, Rigel says, is "how the rise in melanoma affects our patients."
"We know the cause of melanoma is too much exposure to ultraviolet (UV) radiation, whether from the sun or indoor tanning beds and lamps. Simple behavior changes can lower your risk," he says.
So when should you see a doctor? If a mole is growing, bleeding, crusting, or changing, he says.
Harold S. Rabinovitz, MD, a dermatologist at the University of Miami Miller School of Medicine, says know your ABCs.
Look at your moles and check for:
Asymmetry: one half unlike the other half.
Border: irregular, scalloped or poorly defined.
Color: varies from one area to another; shades of tan and brown, black; sometimes white, red or blue.
Diameter: the size of a pencil eraser or larger.
Evolving: changing in size, shape or color.
"A mole with any of these characteristics should be brought to a dermatologist’s attention immediately," Rabinovitz says.