Our knowledge of the epidemiology of malignant melanoma among children and adolescents in multi‐ethnic populations is limited. We evaluated demographic predictors and trends of malignant melanoma incidence in those <21 years old in Texas, a state characterized by a large Hispanic population.
METHODS: We obtained information from the Texas Cancer Registry on all incident cases of cutaneous malignant melanoma diagnosed in 1995‐2013 (n=655). Population estimates were obtained from the 2000 and 2010 U.S. Census. Poisson regression was used to estimate adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) in order to assess associations between demographic factors (sex, age at diagnosis, race/ethnicity and area‐level poverty) and melanoma incidence rates (IR). Joinpoint regression was used to assess the annual percent change (APC) in melanoma IRs over the 1995‐2013 period.
RESULTS: The overall melanoma IR was 4.3 (95% CI: 4.0‐4.6) per 1,000,000. In multivariable analysis, the following groups were associated with an increased melanoma IR: females (aIRR=1.30, 95% CI: 1.1‐1.5), those with older age (15‐20 years old aIRR=10.2, 95% CI: 7.2‐14.3, compared to those <5 years old), non‐Hispanic whites (aIRR=7.9, 95% CI: 5.7‐10.9, compared to non‐Hispanic non‐whites), and those living in low poverty areas (aIRR=1.3, 95% CI: 1.1‐ 1.5). The overall melanoma IR increased by 12.0% (95% CI: 5.2%, 19.2%) per year during 1995‐2004; however, the IR decreased by 7.6% (95% CI: ‐12.6%, ‐2.2%) per year during 2005‐ 2013. In contrast, the IRs for those <10 years old (IR APC=7.2%, 95% CI: 2.8%, 11.7%) and Hispanics (IR APC=5.3%, 95% CI: ‐0.6%, 11.6%) increased over the entire study period (1995‐2013). The IR trends in other demographic groups were similar to the overall IR trend, decreasing after 2004.
CONCLUSION: Our results validate previously reported demographic predictors for malignant melanoma incidence among children and adolescents. In addition, we observed an overall decrease in melanoma IRs since 2004, perhaps a consequence of improved educational interventions on UV exposure. Despite these improvements, our data suggest that melanoma IRs continue to increase in those <10 years old as well as among Hispanics, groups characterized by poorer outcomes.
