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Melanoma Deaths Climb Among Older Men

But younger people are dying less of skin cancer now than 30 years ago

WEDNESDAY, Oct. 9, 2002 (HealthDayNews) -- U.S. death rates from the most severe form of skin cancer rose nearly 160 percent for older men during the last three decades, bucking a trend of fewer such deaths among the younger crowd, a new study shows.

The surge in fatal melanoma cases in older and middle-age white men was largely responsible for the nation's overall death rate from melanoma climbing 50 percent between 1969 and 1999, from two per 100,000 people to three per 100,000.

Melanoma deaths fell for Americans ages 20 to 44 during the same period, dropping by 39 percent for women and 29 percent for men in this age group. The researchers attributed the decrease in deaths among younger people to skin cancer education efforts and more prudent sun-bathing habits.

"They are beginning to reap some of the positive messages from the sun protection campaigns," said Alan Geller, a skin cancer expert at Boston University and lead author of the study.

The study, which looked only at whites -- who have 10 to 15 times as much melanoma as blacks and Hispanics -- appears as a research letter in today's issue of the Journal of the American Medical Association.

Death rates from the disease in women ages 45 to 64 rose 19 percent, from 2.6 to 3.1 people per 100,000, during the study period. Men the same age saw a 66 percent increase in deaths, from 3.8 to 6.3 people per 100,000. The increase for men 65 and older was 157 percent, three times the rate for women in the same age group.

Trends in melanoma incidence mirrored the mortality rates, jumping three-fold and five-fold for middle age and older men, respectively, in the study -- from 19 to 92 per 100,000 in those 65 and up -- but not quite doubling for young men.

Geller said it's not entirely clear why seniors are suffering so much more melanoma now than they did 30 years ago, but the surge reflects more than simply increased diagnosis of the disease. One theory, he said, is that sun exposures during World War II and the Korean conflict might be driving the rise. Another is that bathing suit styles in the 1950s and '60s revealed more skin than before, boosting the risk of cancer.

Geller and his colleagues stressed the importance of looking for suspicious moles and lesions, particularly on the back, and bringing them to the attention of a doctor. Men are especially bad at policing their own skin, with two-thirds of their cases of melanoma discovered by their spouses or their doctors, he added.

Catherine Poole, executive director of the National Melanoma Foundation, in Philadelphia, disputed the notion that Americans are being more cautious about the sun than they were 30 years ago. "Our society still thinks it's pretty healthy to be out there on the beach at noon," she said. "Our kids are playing sports at high noon."

Until the country takes a much dimmer view of the sun, Poole said, public education efforts will continue to fizzle.

This year, almost 54,000 people will be diagnosed with melanoma, and 7,400 will die of the disease, according to the American Cancer Society.

What To Do

For more information on melanoma, try the Melanoma Patients' Information Page or the National Melanoma Foundation. You can also check with the American Cancer Society.

SOURCES: Alan Geller, MPH, RN, associate professor of dermatology, Boston University School of Medicine; Catherine Poole, executive director, National Melanoma Foundation, Philadelphia; Oct. 9, 2002, Journal of the American Medical Association
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