Abstract
Purpose
The purpose of this study is to describe the epidemiology of melanoma among Hispanics using data that cover nearly 100 % of the US population.
Methods
The study used population-based cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology and End Results Program to examine melanoma incidence rates and trends among Hispanics by sex, age, race, histology, anatomic location, stage, and tumor thickness.
Results
From 2008 to 2012, 6,623 cases of melanoma were diagnosed among Hispanics. Rates were higher among males (4.6) than among females (4.0), but females younger than age 55 had higher rates than males. The most common histologic subtype was superficial spreading melanoma (23 %). Melanomas with poorer outcomes, such as nodular (NM) and acral lentiginous melanoma (ALM), were more common among males. Hispanic females had the highest proportion of melanoma on the lower limb and hip (33.7 %), while Hispanic males had the highest proportion on the trunk (29.9 %). Incidence rates for later-stage diagnosis and thicker tumors were significantly higher among Hispanic men than among women. Incidence rates decreased significantly during 2003–2012 (AAPC = −1.4).
Conclusions
Clinicians and public health practitioners will need to reach the growing Hispanic population in the USA with strategies for primary prevention and early diagnosis of melanoma. Results suggest Hispanics and providers need education to increase awareness about the characteristics of melanoma among Hispanics, including types that occur on non-sun-exposed areas (ALM and NM). Skin cancer prevention and awareness interventions targeting Hispanics should be culturally relevant.
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References
U.S. Cancer Statistics Working Group (2015) United States Cancer Statistics: 1999–2012 Incidence and Mortality Web-based Report. Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services and National Cancer Institute, National Institutes of Health. http://www.cdc.gov/uscs. Accessed 1 Sept 2015
U.S. Department of Health and Human Services (2014) The Surgeon General’s call to action to prevent skin cancer. Dept of Health and Human Services, Office of the Surgeon General, Washington, DC
Hu S, Parmet Y, Allen G, Parker DF, Ma F, Rouhani P, Kirsner RS (2009) Disparity in melanoma: a trend analysis of melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida. Arch Dermatol 145(12):1369–1374. doi:10.1001/archdermatol.2009.302
Cockburn MG, Zadnick J, Deapen D (2006) Developing epidemic of melanoma in the Hispanic population of California. Cancer 106(5):1162–1168. doi:10.1002/cncr.21654
Cormier JN, Xing Y, Ding M, Lee JE, Mansfield PF, Gershenwald JE, Ross MI, Du XL (2006) Ethnic differences among patients with cutaneous melanoma. Arch Intern Med 166(17):1907–1914. doi:10.1001/archinte.166.17.1907
Clairwood M, Ricketts J, Grant-Kels J, Gonsalves L (2013) Melanoma in skin of color in Connecticut: an analysis of melanoma incidence and stage at diagnosis in non-Hispanic blacks, non-Hispanic whites, and Hispanics. Int J Dermatol. doi:10.1111/j.1365-4632.2012.05713.x
Cress RD, Holly EA (1997) Incidence of cutaneous melanoma among non-Hispanic whites, Hispanics, Asians, and blacks: an analysis of california cancer registry data, 1988–93. Cancer Causes Control 8(2):246–252
Zell JA, Cinar P, Mobasher M, Ziogas A, Meyskens FL Jr, Anton-Culver H (2008) Survival for patients with invasive cutaneous melanoma among ethnic groups: the effects of socioeconomic status and treatment. J Clin Oncol 26(1):66–75. doi:10.1200/jco.2007.12.3604
Pollitt RA, Clarke CA, Swetter SM, Peng DH, Zadnick J, Cockburn M (2011) The expanding melanoma burden in California Hispanics: importance of socioeconomic distribution, histologic subtype, and anatomic location. Cancer 117(1):152–161. doi:10.1002/cncr.25355
Merrill RM, Pace ND, Elison AN (2010) Cutaneous malignant melanoma among white Hispanics and non-Hispanics in the United States. Ethn Dis 20(4):353–358
Feng Z, Zhang Z, Wu XC (2013) Lifetime risks of cutaneous melanoma by histological subtype and race/ethnicity in the United States. J La State Med Soc 165(4):201–208
Wu XC, Eide MJ, King J, Saraiya M, Huang Y, Wiggins C, Barnholtz-Sloan JS, Martin N, Cokkinides V, Miller J, Patel P, Ekwueme DU, Kim J (2011) Racial and ethnic variations in incidence and survival of cutaneous melanoma in the United States, 1999–2006. J Am Acad Dermatol 65(5 Suppl 1):S26–S37. doi:10.1016/j.jaad.2011.05.034
Agbai ON, Buster K, Sanchez M, Hernandez C, Kundu RV, Chiu M, Roberts WE, Draelos ZD, Bhushan R, Taylor SC, Lim HW (2014) Skin cancer and photoprotection in people of color: a review and recommendations for physicians and the public. J Am Acad Dermatol 70(4):748–762. doi:10.1016/j.jaad.2013.11.038
Bradford PT, Goldstein AM, McMaster ML, Tucker MA (2009) Acral lentiginous melanoma: incidence and survival patterns in the United States, 1986–2005. Arch Dermatol 145(4):427–434. doi:10.1001/archdermatol.2008.609
Rouhani P, Hu S, Kirsner RS (2008) Melanoma in Hispanic and black Americans. Cancer Control 15(3):248–253
Hu S, Sherman R, Arheart K, Kirsner RS (2014) Predictors of neighborhood risk for late-stage melanoma: addressing disparities through spatial analysis and area-based measures. J Invest Dermatol 134(4):937–945. doi:10.1038/jid.2013.465
Wagner JK, Parra EJ, Norton HL, Jovel C, Shriver MD (2002) Skin responses to ultraviolet radiation: effects of constitutive pigmentation, sex, and ancestry. Pigment Cell Res 15(5):385–390
Holman DM, Berkowitz Z, Guy GP, Hartman AM, Perna FM (2014) The association between demographic and behavioral characteristics and sunburn among U.S. adults—National Health Interview Survey, 2010. Prev Med 63:6–12. doi:10.1016/j.ypmed.2014.02.018
Andreeva VA, Unger JB, Yaroch AL, Cockburn MG, Baezconde-Garbanati L, Reynolds KD (2009) Acculturation and sun-safe behaviors among US Latinos: findings from the 2005 Health Information National Trends Survey. Am J Public Health 99(4):734–741. doi:10.2105/ajph.2007.122796
Pinheiro PS, Sherman RL, Trapido EJ, Fleming LE, Huang Y, Gomez-Marin O, Lee D (2009) Cancer incidence in first generation U.S. Hispanics: Cubans, Mexicans, Puerto Ricans, and new Latinos. Cancer Epidemiol Biomark Prev 18(8):2162–2169. doi:10.1158/1055-9965.epi-09-0329
Andreeva VA, Cockburn MG (2011) Cutaneous melanoma and other skin cancer screening among Hispanics in the United States: a review of the evidence, disparities, and need for expanding the intervention and research agendas. Arch Dermatol 147(6):743–745. doi:10.1001/archdermatol.2011.140
Roman C, Lugo-Somolinos A, Thomas N (2013) Skin cancer knowledge and skin self-examinations in the Hispanic population of North Carolina: the patient’s perspective. JAMA Dermatol 149(1):103–104. doi:10.1001/2013.jamadermatol.263
Coups EJ, Stapleton JL, Medina-Forrester A, Natale-Pereira A, Tortolero-Luna G (2014) Sun protection behaviors among Puerto Rican adults. JAMA Dermatol. doi:10.1001/jamadermatol.2013.8852
US Census Bureau (2014) Table 16. Projected rates for components of change by race and Hispanic origin for the United States: 2015 to 2060 (NP2014-T16) US Census Bureau, Population Division http://www.census.gov/population/projections/files/summary/NP2014-T16.xls Accessed 12 Feb 2014
United States Cancer Statistics (USCS) Technical notes: USCS publication criteria. US Department of Health and Human Services, Centers for Disease Control and Prevention, Division of Cancer Prevention and Control. http://www.cdc.gov/cancer/npcr/uscs/technical_notes/criteria.htm. Accessed 29 April 2015
National Cancer Institute Surveillance, Epidemiology and End Results Program Website. US Dept of Health and Human Services, National Institutes of Health, National Cancer Institute. http://seer.cancer.gov/. Accessed 26 May 2015
National Program of Cancer Registries National Program of Cancer Registries Website. US Dept of Health and Human Services, Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/npcr/. Accessed 26 May 2015
Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence—SEER 18 Regs Research Data + Hurricane Katrina Impacted Louisiana Cases, Nov 2014 Sub (2000–2012) <Katrina/Rita Population Adjustment>—Linked To County Attributes—Total U.S., 1969–2013 Counties, National Cancer Institute, Division of Cancer Control and Population Sciences, Surveillance Research Program, Surveillance Systems Branch, released April 2015, based on the November 2014 submission
NAACCR Race and Ethnicity Work Group (2011) NAACCR Guideline for enhancing Hispanic/Latino identification: revised NAACCR Hispanic/Latino identification algorithm [NHIA v2.2.1]. North American Association of Central Cancer Registries, Springfield
Collaborative Staging Task Force of the American Joint Committee on Cancer (2004) Collaborative Staging Manual and Coding Instructions, version 01.03.00
Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control, National Institutes of Health’s National Cancer Institute (2015) United States Cancer Statistics Restricted Access Data Set Data Dictionary and Data Standards, 2014 November data submission. US Dept of Health and Human Services, Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Cancer Surveillance Branch, Atlanta, GA, and National Institutes of Health, National Cancer Institute, Surveillance Research Program, Bethesda, MD
Surveillance Research Program NCI SEER Stat Fact Sheets: Melanoma of the Skin. US Department of Health and Human Services, National Institutes of Health, National Cancer Institute. http://seer.cancer.gov/statfacts/html/melan.html. Accessed 23 April 2015
Weir HK, Marrett LD, Cokkinides V, Barnholtz-Sloan J, Patel P, Tai E, Jemal A, Li J, Kim J, Ekwueme DU (2011) Melanoma in adolescents and young adults (ages 15–39 years): United States, 1999–2006. J Am Acad Dermatol 65(5 suppl 1):S38–S49. doi:10.1016/j.jaad.2011.04.038
Populo H, Boaventura P, Vinagre J, Batista R, Mendes A, Caldas R, Pardal J, Azevedo F, Honavar M, Guimaraes I, Manuel Lopes J, Sobrinho-Simoes M, Soares P (2014) TERT promoter mutations in skin cancer: the effects of sun exposure and X-irradiation. J Invest Dermatol 134(8):2251–2257. doi:10.1038/jid.2014.163
Phan A, Touzet S, Dalle S, Ronger-Savle S, Balme B, Thomas L (2006) Acral lentiginous melanoma: a clinicoprognostic study of 126 cases. Br J Dermatol 155(3):561–569. doi:10.1111/j.1365-2133.2006.07368.x
Durbec F, Martin L, Derancourt C, Grange F (2012) Melanoma of the hand and foot: epidemiological, prognostic and genetic features. A systematic review. Br J Dermatol 166(4):727–739. doi:10.1111/j.1365-2133.2011.10772.x
United States Cancer Statistics: 1999–2012 Mortality, WONDER Online Database. United States Department of Health and Human Services, Centers for Disease Control and Prevention (2015). http://wonder.cdc.gov/CancerMort-v2012.html Accessed 17 Nov 2015
Fish JA, Prichard I, Ettridge K, Grunfeld EA, Wilson C (2015) Psychosocial factors that influence men’s help-seeking for cancer symptoms: a systematic synthesis of mixed methods research. Psycho-oncology. doi:10.1002/pon.3912
Caini S, Gandini S, Sera F, Raimondi S, Fargnoli MC, Boniol M, Armstrong BK (2009) Meta-analysis of risk factors for cutaneous melanoma according to anatomical site and clinico-pathological variant. Eur J Cancer 45(17):3054–3063. doi:10.1016/j.ejca.2009.05.009
Cho E, Rosner BA, Colditz GA (2005) Risk factors for melanoma by body site. Cancer Epidemiol Biomark Prev 14(5):1241–1244. doi:10.1158/1055-9965.epi-04-0632
Lachiewicz AM, Berwick M, Wiggins CL, Thomas NE (2008) Survival differences between patients with scalp or neck melanoma and those with melanoma of other sites in the Surveillance, Epidemiology, and End Results (SEER) program. Arch Dermatol 144(4):515–521. doi:10.1001/archderm.144.4.515
Anderson WF, Pfeiffer RM, Tucker MA, Rosenberg PS (2009) Divergent cancer pathways for early-onset and late-onset cutaneous malignant melanoma. Cancer 115(18):4176–4185. doi:10.1002/cncr.24481
Chang YM, Barrett JH, Bishop DT, Armstrong BK, Bataille V, Bergman W, Berwick M, Bracci PM, Elwood JM, Ernstoff MS, Gallagher RP, Green AC, Gruis NA, Holly EA, Ingvar C, Kanetsky PA, Karagas MR, Lee TK, Le Marchand L, Mackie RM, Olsson H, Osterlind A, Rebbeck TR, Sasieni P, Siskind V, Swerdlow AJ, Titus-Ernstoff L, Zens MS, Newton-Bishop JA (2009) Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5,700 cases and 7,216 controls. Int J Epidemiol 38(3):814–830. doi:10.1093/ije/dyp166
Karagas M, Weinstock MA, Nelson HH (2006) Keratinocyte carcinomas (basal and squamous cell carcinomas of the skin). In: Schottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention, 3rd edn. Oxford University Press, New York, pp 1230–1250
Gandini S, Sera F, Cattaruzza MS, Pasquini P, Picconi O, Boyle P, Melchi CF (2005) Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer 41(1):45–60. doi:10.1016/j.ejca.2004.10.016
Whiteman DC, Stickley M, Watt P, Hughes MC, Davis MB, Green AC (2006) Anatomic site, sun exposure, and risk of cutaneous melanoma. J Clin Oncol 24(19):3172–3177. doi:10.1200/jco.2006.06.1325
Hodis E, Watson IR, Kryukov GV, Arold ST, Imielinski M, Theurillat JP, Nickerson E, Auclair D, Li L, Place C, Dicara D, Ramos AH, Lawrence MS, Cibulskis K, Sivachenko A, Voet D, Saksena G, Stransky N, Onofrio RC, Winckler W, Ardlie K, Wagle N, Wargo J, Chong K, Morton DL, Stemke-Hale K, Chen G, Noble M, Meyerson M, Ladbury JE, Davies MA, Gershenwald JE, Wagner SN, Hoon DS, Schadendorf D, Lander ES, Gabriel SB, Getz G, Garraway LA, Chin L (2012) A landscape of driver mutations in melanoma. Cell 150(2):251–263. doi:10.1016/j.cell.2012.06.024
Community Preventive Services Task Force (2013) Preventing skin cancer: interventions in outdoor occupational settings. The Guide to Community Preventive Services website. http://www.thecommunityguide.org/cancer/skin/education-policy/outdooroccupations.html. Accessed 9 Dec 2013
U.S. Department of Labor (2005) Findings from the National Agricultural Workers Survey (NAWS) 2001–2002. A Demographic and Employment Profile of United States Farm Workers. Research Report, No. 9. U.S. Dept of Labor, Washington, DC
Salas R, Mayer JA, Hoerster KD (2005) Sun-protective behaviors of California farm workers. J Occup Environ Med 47(12):1244–1249
Pichon LC, Mayer JA, Slymen DJ, Elder JP, Lewis EC, Galindo GR (2005) Ethnoracial differences among outdoor workers in key sun-safety behaviors. Am J Prev Med 28(4):374–378. doi:10.1016/j.amepre.2005.01.004
Day AK, Stapleton JL, Natale-Pereira AM, Goydos JS, Coups EJ (2015) Occupational sunscreen use among US Hispanic outdoor workers. BMC Res Notes 8:578. doi:10.1186/s13104-015-1558-1
Cheng CE, Irwin B, Mauriello D, Hemminger L, Pappert A, Kimball AB (2010) Health disparities among different ethnic and racial middle and high school students in sun exposure beliefs and knowledge. J Adolesc Health 47(1):106–109. doi:10.1016/j.jadohealth.2009.12.028
Heckman CJ, Cohen-Filipic J (2012) Brief report: ultraviolet radiation exposure, considering acculturation among Hispanics (Project URECAH). J Cancer Educ 27(2):342–346. doi:10.1007/s13187-011-0308-x
Guy GP, Berkowitz Z, Everett Jones S, Holman DM, Garnett E, Watson M (2014) Trends in indoor tanning among US high school students, 2009–2013. JAMA Dermatol. doi:10.1001/jamadermatol.2014.4677
Centers for Disease Control and Prevention (2015) 1991–2013 high school youth risk behavior survey data. US Dept of Health and Human Services, Centers for Disease Control and Prevention. http://nccd.cdc.gov/youthonline/App/Default.aspx. Accessed 12 May 2015
Hillhouse J, Turrisi R, Stapleton J, Robinson J (2008) A randomized controlled trial of an appearance-focused intervention to prevent skin cancer. Cancer 113(11):3257–3266. doi:10.1002/cncr.23922
Moyer VA, U.S. Preventive Services Task Force (2012) Behavioral counseling to prevent skin cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 157(1):59–65. doi:10.7326/0003-4819-157-1-201207030-00442
U.S. Preventive Services Task Force (2012) Behavioral counseling to prevent skin cancer: U.S. Preventive Services Task Force Recommendation Statement website. http://www.uspreventiveservicestaskforce.org/uspstf11/skincancouns/skincancounsrs.htm. Accessed 16 May 2013
Santiago-Rivas M, Wang C, Jandorf L (2014) Sun protection beliefs among Hispanics in the US. J Skin Cancer 2014:161960. doi:10.1155/2014/161960
Buster KJ, You Z, Fouad M, Elmets C (2012) Skin cancer risk perceptions: a comparison across ethnicity, age, education, gender, and income. J Am Acad Dermatol 66(5):771–779. doi:10.1016/j.jaad.2011.05.021
Coups EJ, Stapleton JL, Manne SL, Hudson SV, Medina-Forrester A, Rosenberg SA, Gordon M, Tatum KS, Robinson JK, Natale-Pereira A, Goydos JS (2014) Psychosocial correlates of sun protection behaviors among U.S. Hispanic adults. J Behav Med 37(6):1082–1090. doi:10.1007/s10865-014-9558-5
Kundu RV, Kamaria M, Ortiz S, West DP, Rademaker AW, Robinson JK (2010) Effectiveness of a knowledge-based intervention for melanoma among those with ethnic skin. J Am Acad Dermatol 62(5):777–784. doi:10.1016/j.jaad.2009.08.047
Hu S, Kirsner RS (2011) Practice gaps—suboptimal skin cancer screening and delayed melanoma diagnosis in Hispanics: comment on “cutaneous melanoma and other skin cancer screening among Hispanics in the United States”. Arch Dermatol 147(6):745–746. doi:10.1001/archdermatol.2011.141
Coups EJ, Stapleton JL, Hudson SV, Medina-Forrester A, Rosenberg SA, Gordon MA, Natale-Pereira A, Goydos JS (2013) Linguistic acculturation and skin cancer-related behaviors among Hispanics in the southern and western United States. JAMA Dermatol 149(6):679–686. doi:10.1001/jamadermatol.2013.745
Coups EJ, Stapleton JL, Hudson SV, Medina-Forrester A, Natale-Pereira A, Goydos JS (2012) Sun protection and exposure behaviors among Hispanic adults in the United States: differences according to acculturation and among Hispanic subgroups. BMC Public Health 12:985. doi:10.1186/1471-2458-12-985
Dominguez K, Penman-Aguilar A, Chang MH, Moonesinghe R, Castellanos T, Rodriguez-Lainz A, Schieber R (2015) Vital signs: leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States—2009–2013. MMWR Morb Mortal Wkly Rep 64(17):469–478
Pinheiro PS, Sherman R, Fleming LE, Gomez-Marin O, Huang Y, Lee DJ, Penedo FJ (2009) Validation of ethnicity in cancer data: Which Hispanics are we misclassifying? J Regist Manag 36(2):42–46
Cartee TV, Kini SP, Chen SC (2011) Melanoma reporting to central cancer registries by U.S. dermatologists: an analysis of the persistent knowledge and practice gap. J Am Acad Dermatol 65(5 suppl 1):S124.e001–S124.e009. doi:10.1016/j.jaad.2011.05.032
Thoburn KK, German RR, Lewis M, Nichols PJ, Ahmed F, Jackson-Thompson J (2007) Case completeness and data accuracy in the Centers for Disease Control and Prevention’s National Program of Cancer Registries. Cancer 109(8):1607–1616. doi:10.1002/cncr.22566
Ennis KY, Chen M-H, Smith GC, D’Amico AV, Zhang Y, Quinn SA, Ryemon SN, Goltz D, Harrison LB, Ennis RD (2015) The impact of economic recession on the incidence and treatment of cancer. J Cancer 6(8):727–733. doi:10.7150/jca.11886
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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
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Garnett, E., Townsend, J., Steele, B. et al. Characteristics, rates, and trends of melanoma incidence among Hispanics in the USA. Cancer Causes Control 27, 647–659 (2016). https://doi.org/10.1007/s10552-016-0738-1
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DOI: https://doi.org/10.1007/s10552-016-0738-1