Mayo Clinic study finds dramatic rise in skin cancer in young adults

Even as the rates of some cancers are falling, Mayo Clinic is seeing an alarming trend: the dramatic rise of skin cancer, especially among people under 40. According to a study by Mayo Clinic researchers published in the April issue of Mayo Clinic Proceedings, the incidence of melanoma has escalated, and young women are the hardest hit.

“We anticipated we’d find rising rates, as other studies are suggesting, but we found an even higher incidence than the National Cancer Institute had reported using the Surveillance, Epidemiology and End Result database, and in particular, a dramatic rise in women in their 20s and 30s,” says lead investigator Jerry Brewer, M.D., a Mayo Clinic dermatologist. Researchers conducted a population-based study using records from the Rochester Epidemiology Project, a decades-long database of all patient care in Olmsted County, Minn. They looked for first-time diagnoses of melanoma in patients 18 to 39 from 1970 to 2009. The study found the incidence of melanoma increased eightfold among young women and fourfold among young men. The lifetime risk of melanoma is higher in males than females, but the opposite is true in young adults and adolescents, Dr. Brewer says.

Researchers also found mortality rates from the disease have improved over the years, likely due to early detection of skin cancer and prompt medical care.

“People are now more aware of their skin and of the need to see a doctor when they see changes,” Dr. Brewer says. “As a result, many cases may be caught before the cancer advances to a deep melanoma, which is harder to treat.”

The researchers speculate that the use of indoor tanning beds is a key culprit in the rising cancer rate in young women.

“A recent study reported that people who use indoor tanning beds frequently are 74 percent more likely to develop melanoma, and we know young women are more likely to use them than young men,” Dr. Brewer says. Despite abundant information about the dangers of tanning beds, he adds, young women continue to use them. “The results of this study emphasize the importance of active interventions to decrease risk factors for skin cancer and, in particular, to continue to alert young women that indoor tanning has carcinogenic effects that increase the risk of melanoma.”

Skin Cancer on the Rise
The number of nonmelanoma skin cancers continues to rise, with an estimated 3.7 million cases in the U.S. in 2009.

That’s the latest figure from researchers who last year reported that more than 2 million Americans were treated for 3.5 million nonmelanoma skin cancers - mainly basal cell and squamous cell carcinomas - in 2006.

Although these skin cancers can be easily treated if detected early, “the long-established culture of tanning is creating a huge public health problem,” says Brett M. Coldiron, MD, clinical associate professor of dermatology at the University of Cincinnati.

Janey Helland, of Mapleton, Minn., didn’t think twice when tanning in high school and college.

“I used tanning beds to get ready for homecoming and prom,” she says. “In college, I tanned before a trip to Barbados because I didn’t want to get sunburned.” At age 21, Helland noticed an abnormal spot on her leg. It was melanoma, and the diagnosis changed Helland’s life. “I really didn’t know what my future was going to look like, or if I’d even have one.”

For both studies, Coldiron and colleagues used Medicare claims data to count the number of skin cancer removal procedures among Medicare recipients and extrapolated figures to the rest of the population.

Their earlier report, published last year in the Archives of Dermatology, showed skin cancer removals among Medicare patients increased on average 4% a year from 1992 to 2006.

The new findings, presented at the annual meeting of the American Academy of Dermatology (AAD), showed that procedures among Medicare patients increased an additional 2.4% from 2006 to 2007, 2.6% from 2007-2008, and an additional 1.6% in 2009.

Two years later, she is cancer-free and dedicated to educating others. “I would advocate that it’s better to be safe than sorry,” she says. “My advice is to educate yourself and research the risk factors.”

Childhood sunburns and ultraviolet exposure in adulthood may also contribute to melanoma development, the researchers say.

Rates of deadly skin cancer have almost doubled in some areas in less than a decade, stark figures showed yesterday.

Across England, rates of malignant melanoma have shot up by 46 per cent in just seven years - making it the fastest growing cancer.

But in Yorkshire, there were 80 per cent more cases of this type of skin cancer in 2004 than in 1997, as people ignore warnings to stay out of the sun.

The Conservatives, who uncovered the disturbing statistics, slammed the Government for ignoring the risk and cutting funding for campaigns to educate people about the dangers of over-exposure.

Health spokesman Andrew Lansley said: “These figures are deeply concerning, especially the stark regional disparities.

“A relatively high level of melanoma is to be expected in sunnier regions where there is more outdoor activity as in the south west, but this is not the case in the north where incidences have risen well above the national average.

“In their dithering and short-term thinking, Labour have failed to make helping people understand how to stay healthy a priority.

“It’s telling that they cut funding for their main information campaign against skin cancer just after the worst of the NHS financial crisis.

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The study was funded in part by the National Institutes of Health. Other authors include Kurtis Reed, M.D., Christine Lohse, Kariline Bringe, Crystal Pruitt, and Lawrence Gibson, M.D. all of Mayo Clinic.

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Alyson Fleming
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Mayo Clinic

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