{"id":743,"date":"2015-06-23T11:00:17","date_gmt":"2015-06-23T11:00:17","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=743"},"modified":"2017-08-21T11:45:06","modified_gmt":"2017-08-21T11:45:06","slug":"primary-care-corner-with-geoffrey-modest-md-melanoma-increasing-a-lot","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2015\/06\/23\/primary-care-corner-with-geoffrey-modest-md-melanoma-increasing-a-lot\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Melanoma increasing (a lot)"},"content":{"rendered":"

By: Dr. Geoffrey Modest<\/strong><\/p>\n

MMWR just released an analysis of melanoma incidence,\u00a0mortality trends,\u00a0and projections\u00a0in the US\u00a0from 1982-2030 (see here<\/a>). Melanoma is common (5th most common cancer in men and 7th in women) and is\u00a0associated with the most skin cancer deaths,\u00a0with deaths occurring most frequently in younger people (average of\u00a020.4 years of potential life lost). Costs of treatment are high ($3.3 billion\/yr in the US). And\u00a0melanoma is largely\u00a0preventable —\u00a090% are attributable to skin damage from UV light exposure, with sunburns being a significant risk factor and\u00a040% of US people reporting sunburn every year. There is\u00a0clear efficacy of sun-protective behaviors in decreasing UV skin\u00a0exposure,\u00a0such as sunscreen, protective clothing. <\/span>I<\/span>n addition\u00a0there are\u00a0suggestive data that cumulative UV radiation exposure over time may also be a culprit.\u00a0results from MMWR:<\/span><\/p>\n

–in 2011: 65,647 invasive melanomas in the US, with age-adjusted incidence rate of 19.7\/100K, increasing with age and highest in non-Hispanic whites,\u00a0in women 15-49yo, and\u00a0in\u00a0men >50.<\/span><\/p>\n

–in 2011: 9,128 melanoma deaths, with age-adjusted death rate of\u00a02.7\/100K, higher in non-Hispanic whites, increasing\u00a0with age, and higher in men (4.0) than women (1.7)<\/span><\/p>\n

–from 1982-2011: melanoma incidence rates increased (doubling), though mortality remained the same.<\/span><\/p>\n

–without intervention, there are projected to be 112,000 new cases in 2030 with annual cost for treatment projected to increase 252.4% from 2011-2030 (from $454 million to $1.6 billion)<\/span><\/p>\n

–a comprehensive skin care prevention program (modeled after the one in Australia, which raised\u00a0community awareness\u00a0through mass media campaigns, programs in schools and workplaces, provider education, etc, had\u00a0projected savings of $2.30 for every $1 spent)\u00a0is estimated to prevent 20% of US\u00a0melanoma cases from 2011-2030, averting 21,000 cases\/yr, and reducing spending $250 million\/yr (saving $2.7 billion\u00a0from 2020-2030).<\/span><\/p>\n

So, this\u00a0seems like a largely preventable problem. <\/span>T<\/span>here are pretty easy individual\u00a0strategies available, including\u00a0not using indoor\u00a0tanning salons and\u00a0<\/span>using appropriate sunscreen protection — correct amount, reapplication rates, etc. \u00a0But,\u00a0as in Australia, the major potential impact would be from concerted, community-oriented and community-based public health initiatives. Some of the above gender differences may be attributable\u00a0to the increased female use of indoor tanning salons (a 2013 report found that approx 1\/3 of non-Hispanic white\u00a0women aged 16-25 use indoor tanning salons each year) <\/span>and decreased male use of sunscreen protection. It is also important to remember that there still is a melanoma risk in darker skinned individuals. Overall black incidence in 2011 was 1.0\/100K, vs 24.6\/100K in non-Hispanic whites; but the mortality in black americans was 0.4\/100K vs 3.1\/100K reflecting a 3-fold increased mortality-to-incidence ratio vs non-Hispanic whites. This higher mortality is perhaps related to data suggesting that darker-skinned people report more frequent sunburns, are less likely to use sun-protection strategies,\u00a0have a higher incidence of\u00a0poorer-survival melanomas perhaps related to later diagnosis, a\u00a0lower perceived risk by patients and providers, and more melanomas in non-sun-exposed areas.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

By: Dr. Geoffrey Modest MMWR just released an analysis of melanoma incidence,\u00a0mortality trends,\u00a0and projections\u00a0in the US\u00a0from 1982-2030 (see here). Melanoma is common (5th most common cancer in men and 7th in women) and is\u00a0associated with the most skin cancer deaths,\u00a0with deaths occurring most frequently in younger people (average of\u00a020.4 years of potential life lost). Costs […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-743","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/743","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=743"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/743\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=743"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=743"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=743"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}