Melanoma Rates Rising in U.S. Children

Deadly skin cancer still rare in kids, but long-term study found 2 percent yearly increase among whites

By Denise Mann

HealthDay Reporter

WEDNESDAY, April 3 (HealthDay News) -- Melanoma, the most deadly form of skin cancer, doesn't usually occur in kids, but a new study shows that it's happening more often.

While melanoma in children is still extremely rare, the rate increased by about 2 percent per year from 1973 to 2009 among U.S children from newborns to age 19. Melanoma accounts for up to 3 percent of all pediatric cancers, according to the Skin Cancer Foundation.

According to the study, 1,317 children were diagnosed with melanoma during the study time frame. Of these, 1,230 children were white. Because the number of melanoma cases among other racial and ethnic groups was so small, researchers focused the analysis on white children.

The biggest jump in melanoma rates was seen among adolescents aged 15 to 19, especially girls, the study showed.

The new findings were published in the May print issue of Pediatrics.

Recent studies have also shown that melanoma is on the rise among adults as well. Exactly what is driving these trends is not fully understood, but increased exposure to ultraviolet radiation from both the sun and tanning booths as well as greater awareness of melanoma may be responsible, according to study authors led by Jeannette Wong of the U.S. National Cancer Institute.

The researchers used a database to capture trends in childhood melanoma, but they did not have any information on participants' tanning habits or sun exposure history.

Boys were more likely to develop melanomas on their face and trunks, while girls were more likely to have melanoma on their lower legs and hips, the investigators found. Other risks for melanoma among children and adults include fair skin, light-colored hair and eyes, moles, family history of melanoma and a history of sunburns.

Dr. Amy Forman Taub, a dermatologist in Lincolnshire, Ill., said that tanning behaviors have a lot to do with the increasing rates of melanoma in children and adults. "It's the tanning booths and the fact that we go away on vacation where we are exposed to a lot of intense sun," she said.

Genes may also play a role, suggested Taub, who was not involved in the new study.

Melanoma in kids looks pretty similar to melanoma in adults, Taub said. They have irregular borders, are asymmetrical -- if you cut them in half, you would not get two equal sides -- have uneven colors, and a diameter that is greater than 6 millimeters (about one-fifth of an inch). "Parents should be aware of any new or changing moles in their children," she advised.

Choosing a sunscreen that blocks both ultraviolet A and ultraviolet B rays and reapplying it frequently is important, she said. Sun-smart clothing can also help protect children.

Dr. Ana Duarte, director of pediatric dermatology at Miami Children's Hospital, agreed. "Early diagnosis of melanoma is beneficial," she said, and the importance of protection can't be overstated. "Sunscreen and or sun protection are so important for children," Duarte said, and whatever you do, "don't ignore changing moles, even in children, because melanoma can occur in kids."

Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City, said the new study puts childhood melanoma on the radar, and that's a good thing.

"It is rare, but children do get melanoma," Green said. "When in doubt, get it checked out. The good news is that we know how to prevent melanoma, and when we catch it early, we have really good cure rates."

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Category: Health News
Created: 3/29/2013 12:35:00 PM
Last Editorial Review: 4/1/2013 12:00:00 AM

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Vision Problems Rising Rapidly in the U.S.

Dec. 11, 2012 -- The diabetes and obesity epidemics may be fueling a dramatic rise in the number of people with vision problems, a new study suggests.

Rates of vision problems that can’t be treated with glasses or contact lenses, known as nonrefractive vision problems, increased by 21% between two survey periods: 1999 to 2002 and 2005 to 2008. The findings suggest that as many as 700,000 more people developed these types of vision problems in a short amount of time.

Nonrefractive vision problems include glaucoma, macular degeneration, cataracts, and diabetes-related eye disease. They are caused by underlying diseases. Many of these diseases are age-related and would not be expected to increase among young people. Diabetes, however, is occurring in younger and younger people.

“The increasing diabetes prevalence in the U.S. is leading to more vision loss,” says researcher David S. Friedman, MD, PhD, MPH. He is the director of the Dana Center for Preventive Ophthalmology at the Johns Hopkins Wilmer Eye Institute and Bloomberg School of Public Health in Baltimore. “We have to recognize that this is a large public health problem so we can start developing methods to deal with it.”

The findings appear in the Dec. 12 issue of the Journal of American Medical Association.

Friedman and colleagues analyzed data from a large national database in 1999-2002 and 2005-2008. Participants aged 20 or older answered questions and underwent lab tests and physical exams.  

Those most at risk were older, poorer, had less education, and had diabetes for 10 or more years. The only one of these risks that increased between the two surveys was a history of diabetes.

“The number of people who have had diabetes for more than 10 years has more than doubled in the last six or seven years,” Friedman says. The new findings are likely just the tip of the iceberg. If current diabetes rates continue, “we will see more and more people with diabetes and vision impairment.”

Preventing diabetes in the first place is key to preserving vision, he says. This includes losing weight (if necessary), eating a healthier diet, and getting regular exercise. But, he says, “if you have diabetes, make sure get your eyes checked, as this type of vision loss is preventable.”

Alan N. Carlson, MD, says that it is too early to say that the increase in vision problems is driven by diabetes. “Diabetes is on the rise and vision problems are on the rise, and patients with diabetes are more likely to have eye problems, but that is all we can say right now.” He is the chief of the corneal and refractive surgery services at the Duke Eye Center in Durham, N.C.

“Certainly people need to be aware of the risks of getting nonrefractive vision impairment down the road,” he says. “If there is a family history of certain diseases like macular degeneration, glaucoma, or diabetes, you should be seen more regularly by an eye doctor to make sure these diseases are caught earlier when they are much more treatable.”

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