Changing age distribution of melanoma patients: a 22-year, single-site perspective

To investigate possible changes in the demographics of patients with melanoma during a period of 22 years in one dermatopathology practice.

We performed a retrospective review of 1835 cases of in situ and invasive melanomas histologically diagnosed between 1989 and 2010 in a private dermatopathology laboratory in Norfolk, Virginia. The age and sex of patients with in situ and invasive melanomas were recorded and compared with similar data for patients from whom any histopathologic specimen was received during the same interval. These data were then compared with those in the national Surveillance, Epidemiology, and End Results (SEER) registry between 1989 and 2009.

The number of melanomas diagnosed in the laboratory increased during the 22 study years, but the proportion of submitted specimens diagnosed as melanoma remained somewhat stable. Patient ages ranged from the teens to the ninth decade of life. The proportion of melanomas in the in situ stage gradually increased. Mean patient age rose from 52.4 years in 1989 to 60.7 years in 2010. Men and women aged 60 years and older made up an increasing proportion of melanoma cases. There also was a relative increase in the proportion of women in the 40- to 50-year-old age group and a slight increase among those aged 20 to 30 years, particularly for invasive lesions. In general, the trends were similar for in situ and invasive melanomas. Our data were consistent with the SEER data in showing a trend for decreasing proportion of melanomas in younger individuals, with a corresponding increase in the middle-age and older adult populations. Some differences between the two datasets emerged for men aged 70 to 80, women aged 60 to 70, and all patients aged 70 to 80.

An increasing proportion of melanomas were diagnosed in older individuals. There also was a relative increase in women aged 40 to 50 years and a lesser increase in those aged 20 to 30 years. Our findings were consistent with the national trends observed in the SEER dataset.