Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Acknowledgements
- Historical introduction
- PART I Epidemiological methods
- PART II Causative factors in human cancer
- PART III Legal and ethical considerations
- PART IV Introduction: total and specific site epidemiology
- PART V Buccal cavity
- PART VI Digestive system
- PART VII Respiratory system
- PART VIII Bone and soft tissue
- PART IX Skin
- 38 Malignant melanoma
- 39 Skin cancers other than malignant melanoma
- PART X Breast and genitourinary system
- PART XI Eye and nervous system
- PART XII Thyroid and other endocrine glands, lymphoid and hematopoietic system
- PART XIII Cancers in children and multiple primary cancers
- Conclusions
- Appendix 1 Cancer statistics
- Appendix 2 A glossary of epidemiological terms
- Appendix 3 Acronyms and abbreviations
- Supplement
- Index
38 - Malignant melanoma
Published online by Cambridge University Press: 03 May 2010
Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Acknowledgements
- Historical introduction
- PART I Epidemiological methods
- PART II Causative factors in human cancer
- PART III Legal and ethical considerations
- PART IV Introduction: total and specific site epidemiology
- PART V Buccal cavity
- PART VI Digestive system
- PART VII Respiratory system
- PART VIII Bone and soft tissue
- PART IX Skin
- 38 Malignant melanoma
- 39 Skin cancers other than malignant melanoma
- PART X Breast and genitourinary system
- PART XI Eye and nervous system
- PART XII Thyroid and other endocrine glands, lymphoid and hematopoietic system
- PART XIII Cancers in children and multiple primary cancers
- Conclusions
- Appendix 1 Cancer statistics
- Appendix 2 A glossary of epidemiological terms
- Appendix 3 Acronyms and abbreviations
- Supplement
- Index
Summary
Introduction
In 1950, the sixth revision of the ICD separated malignant melanoma (MM) of the skin from other forms of cutaneous cancer for the first time. Its clinical behavior is considerably more aggressive than the latter. The five-year survival rate is at best around 80% compared to virtually 100% for basal cell carcinoma.
Histology, classification and diagnosis
Malignant melanoma arises from the pigment-producing cells of the skin. Clinical diagnosis, which may not always be easy, is confirmed by histology. Approximately 70% of tumors probably arise in an existing pigmented nevus. The superficial spreading form constitutes around 60% of all malignant melanomas and is frequently indolent. Nodular melanoma (15%) grows rapidly being invasive ab initio. Lentigo malignant melanoma is very slow growing and occurs usually on the face of older persons and represents the most frequent of other forms. Prognosis is deduced from histological examination (Clark, 1969). Tumors less than 0.85 mm thick have a 90% five-year survival; over 4.65 mm a 40% five-year survival (Breslow, 1980).
The topographical distribution of malignant melanoma varies by sex, being commoner on the trunk in males and on the extremities in females.
Descriptive epidemiology
Incidence
The incidence of malignant melanoma of the skin varies by about 100 fold. Incidence is greatest in fair-skinned populations living in sunny climates, e.g. Hawaii, New Zealand. Rates in whites in Los Angeles and New Mexico are double those in New York State. The highest rates are in Australasia.
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- Human CancerEpidemiology and Environmental Causes, pp. 365 - 369Publisher: Cambridge University PressPrint publication year: 1992
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