Improving Melanoma Awareness in Men

In 2012, approximately 76,250 new cases of invasive melanoma will be diagnosed in the United States, and more men than women are expected to be affected — 44,250 vs. 32,000 — the National Cancer Institute projects.

Melanoma is the least common, but deadliest, of the three types of skin cancers. To put it in perspective, melanoma accounts for less than 5% of all skin cancers, but in 2012 is expected to result in approximately 9,180 deaths compared with the 3,010 deaths related to basal cell or squamous cell carcinoma.1,2

In addition to having a higher melanoma-incidence rate than women, men are more likely to die from this form of skin cancer. Among the 8,790 melanoma-related deaths reported in the United States in 2011, just 3,040 occurred in women (35%).3

Several behavioral and etiological factors may help explain gender differences in melanoma incidence and mortality, researchers suggest.

Men tend to have lower levels of awareness about melanoma, knowledge about when to be screened, and general concern for their own well-being, Vernon K. Sondak, MD, of the Moffitt Cancer Center and University of South Florida College of Medicine, Tampa, FL, reported in the Journal of the Clinical Oncology.3

“Possibly as a direct consequence of these behavioral traits, men — especially older men — present with thicker tumors and an attendant increased mortality risk,” the researchers wrote.

Furthermore, women diagnosed with melanoma tend to fare better than men, regardless of the stage of cancer, suggesting that an underlying biological mechanism may be at play.

In a pooled analysis of more than 2,500 patients with localized stage I or II melanoma, women had significantly better rates of overall survival, melanoma-specific survival, and time to lymph node and distant metastases. “These advantages were consistently in the 30% range, even when adjusted for other prognostic factors, and were consistent across various subgroups and in younger (presumably premenopausal) and older (postmenopausal) age groups,” Sondak and colleagues wrote.

As a clinician, you can help bridge gender disparities in melanoma incidence and survival by promoting awareness about the condition among your male patients, as well as by making regular referrals for annual skin exams.

What is melanoma?
Also known as “black tumor,” melanoma originates in melanocytes, the cells that form melanin — a dark, protective pigment that gives skin its color.4 Melanocytes are prone to spread over the course a person's life, but the results are not always harmful. Melanocytes can cause noncancerous skin growths, but when growth cannot be contained or controlled, melanoma occurs.5

The first signs of melanoma are in the epidermis and top layers of the dermis. Later, as the disease progresses, melanoma cells are also found in lymph nodes and blood vessels. Melanomas are initially flat, though they can become raised and dome-shaped. In men, the most common sites are the head, middle of the body and trunk. The arms and legs are the most commonly affected body areas in women. 5