Differences in malignant melanoma between children and adolescents - A 35-year epidemiological study

Objective: To investigate whether there was an increase of malignant melanoma in children. Malignant melanomas are rare in people younger than 20 years. Although melanoma represents one of the most rapidly increasing neoplasm in adults, it is rarely studied in children. Design: Retrospective study from 1958 through 1992. Setting: The compulsory Swedish Cancer Registry in Stockholm, Sweden. Patients: We present 287 cases of malignant melanoma in patients younger than 20 years during 35 years in Sweden. Intervention: None. Main Outcome Measures: Data from cancer reports and death certificates in Sweden. Results: The study shows a strong increase in malignant melanomas in puberty after a presumably constant prevalence before the age of 14 years. The melanomas are more common in females (162) than males (125). The distribution was the same as in adults. Of 287 cases, 44 patients died as a result of their tumors (15.3%), with a median survival time of 3 years after diagnosis. Conclusions: The incidence of malignant melanoma during adolescence has doubled in 10 years. This is not the case for the incidence of melanomas in children younger than 14 years, which seems to be unchanged. It is necessary to be aware of the risk of malignant melanomas in children after puberty.