Trends in Melanoma Prevalence and Risk Factors by Skin Reactions to Sun Exposure in the U.S. Population (1999-2018)

To examine the trends in melanoma prevalence among U.S. adults from 1999 to 2018, considering the role of skin reaction to sun exposure, body mass index (BMI), age, sex, and race/ethnicity. Cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning ten continuous 2-year cycles from 1999-2000 to 2017-2018. A nationally representative survey of the U.S. civilian, non-institutionalized population. The study identified significant trends in melanoma prevalence across various demographic groups. A history of severe sunburn with blisters (OR, 3.94; 95% CI, 1.28-12.15) and severe sunburn for a few days with peeling (OR, 4.67; 95% CI, 2.01-10.84) were associated with higher odds of melanoma. Individuals with overweight exhibited a significantly higher prevalence of melanoma (OR, 4.54; 95%CI, 2.36- 8.75), with a clear upward trend over the study period. Non-Hispanic White adults had significantly higher odds of melanoma compared to other racial/ethnic groups (OR, 10.70; 95% CI, 1.44-79.54). Age also influenced melanoma prevalence, with older adults showing the highest prevalence. The findings highlight the significant role of severe sunburns, BMI, age, and race/ethnicity in melanoma prevalence. Public health strategies should focus on sun protection, particularly for those prone to severe sunburns, and address the increasing melanoma rates among individuals with higher BMI. Efforts to reduce disparities in melanoma diagnosis and prevention among racial/ethnic minorities are essential to mitigate this public health burden.