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 The increase in these dangerous skin cancers has been largest among
non-Hispanic white boys and young men, according to the study
published in JAMA Otolaryngology-Head & Neck Surgery.
"I see the findings as an intersection between medicine and public
health," said senior author Nosayaba Osazuwa-Peters of the Saint
Louis University School of Medicine in Missouri. "The literature has
always focused on melanoma and females and tanning. Our study is
showing that we should not just target young girls."
Osazuwa-Peters would like to see melanoma awareness campaigns
reaching out to hair stylists and barbers because they are often the
first to notice "something out of the ordinary" on a client's scalp.
"We need to empower and equip the people who see the scalp the
most," he said. "They need to know what they are looking at so they
don't immediately think it's just a weird birthmark. Teaching lay
people how to recognize the signs of melanoma in the scalp would be
a worthwhile venture."
Spotting head and neck cancers early is important since they tend to
be more lethal than similar cancers on other parts of the body,
Osazuwa-Peters said.
To take a closer look at the incidence of head and neck melanomas,
Osazuwa-Peters and colleagues turned to the North American
Association of Central Cancer Registries. That dataset includes
cancers diagnosed in both the U.S. and Canada.
The researchers opted to focus on 12,462 patients aged 0 to 39 years
who were diagnosed with head and neck melanomas from 1995 to 2014 in
26 U.S. states and six Canadian provinces. Twenty-four states were
left out of the analysis because they were missing data for some
years.
The states included in the study were Arizona; California; Colorado;
Connecticut; Delaware; Florida; Hawaii; Idaho; Illinois; Iowa;
Kentucky; Louisiana; Maine; Michigan; Nebraska, New Jersey, New
York, North Carolina, Pennsylvania, Rhode Island, Texas, Utah;
Washington; West Virginia; Wisconsin and Wyoming. The Canadian
provinces were Alberta; British Columbia; Manitoba; New Brunswick;
Ontario and Saskatchewan.
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Overall, the incidence of head and neck cancers in North America
increased by 51.1% between 1995 and 2014. However, between 1995 and
2000, head and neck melanoma incidence increased by 4.68% per year
in the U.S., then slowed to 1.15% per year between 2000 and 2014. In
Canada, incidence steadily increased by 2.18% per year between 1995
and 2014.
Older age, male gender and non-Hispanic white race/ethnicity were
all associated with an increased incidence of head and neck
melanoma.
The researchers don't know why there are more head and neck cancers
among boys and men, but they suspect it may be partly related to
lack of hair covering the skin of the head and neck. Females
probably get some protection from the sun because they are more
likely wear their hair long. Males not only tend to wear their hair
shorter but also are more likely to experience thinning or going
completely bald by the time they are in their late 30s, Osazuwa-Peters
said.
Dr. Jason Luke agrees that hair may at least partly explain why head
and neck melanomas are more common among men than women.
Overall, the findings suggest that public health messages be updated
to target both males and females, said Luke, a melanoma specialist
and an associate professor of medicine at UPMC and the University of
Pittsburgh.
"We need to talk to all young people about the risk," Luke said.
SOURCE: https://bit.ly/354qx5Z and https://bit.ly/2LJEyyn JAMA
Otolaryngology-Head & Neck Surgery, online October 3, 2019.
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