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Thick melanoma: the challenge persists
C S Murray1, D L Stockton, V R Doherty
1Department of Dermatology, 1st Floor Lauriston Building, Royal Infirmary of Edinburgh, 1 Lauriston Place, Edinburgh EH3 9YP, UK. CarolineSianMurray@ed.ac.uk
The British Journal of Dermatology
|January 20, 2005
Summary
Despite increased melanoma prevention efforts, the number of thick melanoma cases remains constant. This suggests current strategies are ineffective for this patient group, necessitating new approaches for early detection and treatment.
Area of Science:
- Dermatology and Oncology
- Public Health and Epidemiology
Background:
- Significant resources invested in melanoma prevention over 20 years.
- Increased proportion of thin melanomas linked to improved survival rates.
- Focus of study is on thick, poor-prognosis melanoma presentation trends.
Purpose of the Study:
- Analyze Scottish Melanoma Group (SMG) data to determine the proportion of thick melanomas over time.
- Characterize patient demographics and clinical features of thick melanoma presentations.
- Evaluate the impact of prevention strategies on thick melanoma incidence.
Main Methods:
- Utilized SMG database for 915 patients diagnosed with invasive melanoma ≥3.5 mm thick (1979-1998).
- Included patients from South-east Scotland, Tayside, Grampian, and Highland regions.
- Analyzed changes in thick melanoma proportion, patient age, and tumor types over two decades.
Main Results:
- Absolute number of thick melanomas per year remained stable, despite a decrease in their proportion (50.5% to 31.0%).
- The thick melanoma patient group aged, with median age increasing from 66 to 70 years.
- Nodular melanoma remained common but decreased in proportion, with an increase in superficial spreading (SSM) and acral types.
Conclusions:
- Little change in the annual absolute number of thick melanoma cases over 20 years.
- Thick melanoma patients are older with changing subtype prevalence (nodular and SSM most common).
- Current public and professional education strategies appear ineffective for this group; alternative approaches are needed.