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Increasing incidence of cutaneous malignant melanoma in children and adolescents 12–19 years of age in Sweden 1973–92
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1998 (Engelska)Ingår i: Acta Dermato-Venereologica, ISSN 0001-5555, Vol. 78, nr 4, s. 289-292Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

One-hundred-and-seventy-seven cases of cutaneous malignant melanoma were reported to the Swedish National Cancer Registry in subjects below the age of 20 during the period 1973-92. One-hundred-and-fifty-four (87%) were re-examined histologically, and the original diagnosis of primary cutaneous malignant melanoma was verified in 88%. The age-specific mean annual incidence rate increased to 0.5/100,000 in 1983-92 from 0.2/100,000 in 1973-82. Cutaneous malignant melanoma remained extremely rare in children below the age of 12, where only two cases were found. In subjects aged 12-19, the incidence doubled to 93 cases in the second 10-year period compared to 41 in the first. In boys, most of the melanomas occurred on the trunk, and, in girls, on the legs. Sixty-three percent of the melanomas were of the superficial spreading type, which also was the most rapidly increasing type of melanoma. These results emphasize the importance of surveillance and intensified preventive measures in protecting children and adolescents from the harmful effects of excessive exposure to the sun

Ort, förlag, år, upplaga, sidor
1998. Vol. 78, nr 4, s. 289-292
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:liu:diva-14137DOI: 10.1080/000155598441882OAI: oai:DiVA.org:liu-14137DiVA, id: diva2:22699
Tillgänglig från: 2008-11-13 Skapad: 2008-11-13 Senast uppdaterad: 2009-08-19
Ingår i avhandling
1. Cutaneous melanoma in children and adolescents and aspects of naevus phenotype in melanoma risk assessment
Öppna denna publikation i ny flik eller fönster >>Cutaneous melanoma in children and adolescents and aspects of naevus phenotype in melanoma risk assessment
2006 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Cutaneous malignant melanoma (CMM) is one of the most rapidly increasing cancers in the Swedish population. The aetiology of melanoma is a complex interplay between genetics, host characteristics and environmental factors. The host characteristic with the strongest association with CMM is a phenotype with high numbers of common naevi and with dysplastic naevi. The principal environmental factor is sun exposure.

Melanoma risk assessment (paper I)

In a multi-national study including 986 subjects from Sweden, Denmark, the UK, Germany and the Netherlands, the ability of primary care physicians and nurses to identify individuals at increased melanoma risk was assessed. The atypical mole syndrome (AMS) scoring system for melanoma risk was used. The AMS scoring system consists of a five point check list incorporating total body naevus counts, clinically dysplastic naevi and body distribution of naevi. After brief training, the overall agreement in diagnosis between the trained personnel and experienced dermatologists was 94.5% (kappa value 0.70, p<0.05). The study showed that the scoring system successfully can be taught to personnel in primary care.

The naevus phenotype in a population in northern Sweden (paper II)

The naevus phenotype was investigated in a population living in the inland of northern Sweden with a low melanoma incidence. Two hundred and one participants from the community of Storuman were included. The median naevus count was15 common naevi/individual, and the prevalence of dysplastic naevi was 11%. The median naevus count and prevalence of dysplastic naevi were significantly lower than previously described in populations with higher melanoma incidence and higher ambient ultraviolet exposure in southern Sweden. This geographical variation in naevus phenotype might be explained by differences in levels of sun exposure and in genotype.

Cutaneous malignant melanoma in children and adolescents (papers III–V)

During the years 1973 to 2002, 250 cases of primary CMM in individuals aged 0-19 years were reported to the Swedish Cancer Registry. Histological material was available for review in 87% of the cases registered during the two first decades (1973–1992). The diagnostic accuracy in the reviewed material was 88%.

The melanoma incidence doubled in teenagers between the first decade (1973–1982) and the second (1983–1992). During the third decade (1993–2002) the increasing trend was broken. A decrease in incidence was noted in boys during 1993–1997, and in girls during 1998–2002. In younger children the incidence remained extremely low, only 4 cases in children aged 0–9 years were reported during the studied 30-year period. The trunk was the most common melanoma site in boys, and legs and trunk were the most common sites in girls. Superficial spreading melanoma was the most frequent subtype, followed by nodular melanoma. During the two first decades (1973–1992), the median melanoma thickness decreased from 1.5 to 0.9 mm. The melanoma-specific 5-year survival rate was 93%. The most important prognostic factor was melanoma thickness. The prognosis for thin lesions was excellent, during a median follow up time of 12 years, no tumour less than 0.8 mm was lethal according to the Registry.

The results indicate that CMM in teenagers has many features in common with adult onset melanoma. The tudy also underlines the importance of not neglecting lesions suspected for malignant change in children and adolescents, as early detection and removal is crucial for the prognosis also in this young age group.

Ort, förlag, år, upplaga, sidor
Institutionen för biomedicin och kirurgi, 2006
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 961
Nyckelord
melanoma, naevus, childhood, adolescence, prevention, epidemiology
Nationell ämneskategori
Dermatologi och venereologi
Identifikatorer
urn:nbn:se:liu:diva-7703 (URN)91-85643-73-4 (ISBN)
Disputation
2006-11-03, Eken, Campus US, Linköpings Universitet, Linköping, 09:00 (Engelska)
Opponent
Handledare
Anmärkning

The electronic version of the thesis is a corrected version of the printed version.

Tillgänglig från: 2006-11-09 Skapad: 2006-11-09 Senast uppdaterad: 2020-03-29

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