Melanoma diagnosis in women associated with higher socioeconomic status

The incidence of melanoma appears higher in non-Hispanic white adolescent girls and young women living in higher socioeconomic neighborhoods than those living in lower socioeconomic areas, according to a report posted online today that will appear in the July print issue of Archives of Dermatology.

"Melanoma is the most lethal form of skin cancer and represents a substantial cause of productive years of life lost to cancer, especially when occurring in young persons," the authors write as background information in the study. "Among non-Hispanic white girls and women aged 15 to 39 years in the United States, age-adjusted incidence rates of cutaneous melanoma among adolescents have more than doubled during a 3-decade period (1973-2004), with a 2.7 percent increase annually since 1992."

To assess the relationship between the incidence of melanoma and socioeconomic status and UV-radiation exposure, Amelia K. Hausauer, B.A., of the Cancer Prevention Institute of California and the School of Medicine, University of California San Francisco, and colleagues examined data from the California Cancer Registry. The authors focused on melanoma diagnoses that occurred January 1, 1988 through December 31, 1992 and January 1, 1998 through December 31, 2002.

Data were included from a total of 3,800 non-Hispanic white girls and women between the ages of 15 and 39, in whom 3,842 melanomas were diagnosed. Regardless of the year of diagnosis, adolescent girls and young women living neighborhoods with the highest socioeconomic status were nearly 6-fold more likely to be diagnosed with malignant melanoma than those living in the lowest socioeconomic status.

When examining melanoma incidence by socioeconomic status, diagnosis increased over time in all groups, however these changes were only significant among adolescent girls and young women in the highest three levels of socioeconomic status. Increasing levels of socioeconomic status were positively correlated with higher risks of developing melanoma. Additionally, higher rates of UV-radiation exposure were associated with increased rates of melanoma only among adolescent girls and young women in the highest two levels of socioeconomic status.

Girls and women living in neighborhoods with the highest socioeconomic status and highest UV-radiation exposure experienced 73 percent greater melanoma incidence relative to those from neighborhoods with the lowest socioeconomic status and highest UV-radiation, and an 80 percent greater melanoma incidence relative to those living in neighborhoods with the lowest socioeconomic status and lowest UV-radiation exposure.

"Understanding the ways that socioeconomic status and UV-radiation exposure work together to influence melanoma incidence is important for planning effective prevention and education efforts," the authors conclude. "Interventions should target adolescent girls and young women living in high socioeconomic status and high UV-radiation neighborhoods because they have experienced a significantly greater increase in disease burden."