brand logo

Am Fam Physician. 2006;73(1):139

Clinical Question: Has the incidence of skin melanoma increased?

Setting: Population-based

Study Design: Ecologic

Synopsis: The incidence of skin melanoma is now six times higher than in 1950. The researchers conducting this study attempted to determine if the true incidence is rising or if the increase is caused by an increased biopsy rate. Histologic diagnosis of melanoma is difficult, and several studies have shown that pathologists cannot agree on which samples are really melanoma (Pathology as art appreciation: melanoma diagnosis.http://www.jr2.ox.ac.uk/bandolier/band37/b37-2.html). This study compared skin biopsy rates for patients older than 65 years with the incidence of melanoma over five years in nine geographic areas in the United States. Over the five years, the number of biopsies in this age group increased 2.5-fold, from one out of 35 to one out of 14 persons. The incidence of melanoma increased 2.4-fold, from one out of every 2,222 persons to one out of every 925 persons. Despite this increase in diagnoses, mortality caused by melanoma changed little. These data suggest that the increase in melanoma diagnoses is simply because more lesions are being biopsied that would not have been biopsied in the past.

Bottom Line: This study provides preliminary evidence that the incidence of melanoma is increasing because skin lesions are being biopsied and not because of factors such as skin burns and holes in the ozone layer. (Level of Evidence: 2c)

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, editor-in-chief.

A collection of POEMs published in AFP is available at https://www.aafp.org/afp/poems.

Continue Reading


More in AFP

Copyright © 2006 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.