Melanoma Risk Factors and Prevention



Melanoma is the deadliest of skin cancers and its incidence is the highest among non-Hispanic whites, affecting 26 per 100,000 non-Hispanic whites. Incidence among minority groups is lower with 4 per 100,000 in Hispanics, 1 per 100,000 in blacks and 0.5–1.5 per 100,000 in Asians. Although melanoma occurs much less commonly in individuals of color, the survival rate in non-white patients melanoma is significantly lower. For example, between years 2007–2014, the 5-year survival rate was 91% for white patients and 65% for black patients. Here we will identify the risk factors for melanoma and review the screening guidelines for prevention.


Melanoma Race Ethnicity Health outcomes Risk factors Screening 


  1. 1.
    Rogers HW, Weinstock MA, Feldman SR, et al. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population, 2012. JAMA Dermatol. 2015;151(10):1081–6.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    National Cancer Institute. Surveillance, epidemiology, and end results program. 2018. Available at: Last accessed 6 Mar 2018.
  3. 3.
    Madankumar R, Gumaste PV, Martires K, et al. Acral melanocytic lesions in the United States: prevalence, awareness, and dermoscopic patterns in skin-of-color and non-Hispanic white patients. J Am Acad Dermatol. 2016;74(4):724–30.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Palicka GA, Rhodes AR. Acral melanocytic nevi: prevalence and distribution of gross morphologic features in white and black adults. Arch Dermatol. 2010;146(10):1085–94.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Dawes SM, Tsai S, Gittleman H, et al. Racial disparities in melanoma survival. J Am Acad Dermatol. 2016;75(5):983–91.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    American Cancer Society. Cancer facts & figures 2018. Atlanta, GA: American Cancer Society; 2018.Google Scholar
  7. 7.
    Cress RD, Holly EA. Incidence of cutaneous melanoma among non-Hispanic whites, Hispanics, Asians, and blacks: an analysis of California cancer registry data, 1988–93. Cancer Causes Control. 1997;8(2):246–52.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Byrd KM, Wilson DC, Hoyler SS, et al. Advanced presentation of melanoma in African Americans. J Am Acad Dermatol. 2004;50:21–4; discussion 142–3.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Hu S, Parker DF, Thomas AG, et al. Advanced presentation of melanoma in African Americans: the Miami-Dade County experience. J Am Acad Dermatol. 2004;51(6):1031–2.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Hu S, Soza-Vento RM, Parker DF, et al. Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida. Arch Dermatol. 2006;142(6):704–8.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Hu S, Parmet Y, Allen G, et al. Disparity in melanoma: a trend analysis of melanoma incidence and stage at diagnosis among whites, Hispanics, and blacks in Florida. Arch Dermatol. 2009;145:1369–74.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Cormier JN, Xing Y, Ding M, et al. Ethnic differences among patients with cutaneous melanoma. Arch Intern Med. 2006;166:1907–14.CrossRefGoogle Scholar
  13. 13.
    Wu XC, Eide MJ, King J, et al. Racial and ethnic variations in incidence and survival of cutaneous melanoma in the United States, 1999–2006. J Am Acad Dermatol. 2011;65(5 Suppl 1):S26–37.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Zell JA, Cinar P, Mobasher M, et al. Survival for patients with invasive cutaneous melanoma among ethnic groups: the effects of socioeconomic status and treatment. J Clin Oncol. 2008;26(1):66–75.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Uprety D, Bista A, Chennamadhavuni A, et al. Survival trends among patients with metastatic melanoma in the pretargeted and the post-targeted era: a US population-based study. Melanoma Res. 2018;28(1):56–60.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    O’Keefe EB, Meltzer JP, Bethea TN. Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000–2010. Front Public Health. 2015;3:51.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Harvey VM, Patel H, Sandhu S, et al. Social determinants of racial and ethnic disparities in cutaneous melanoma outcomes. Cancer Control. 2014;21(4):343–9.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Reyes-Ortiz CA, Goodwin JS, Freeman JL, et al. Socioeconomic status and survival in older patients with melanoma. J Am Geriatr Soc. 2006;54:1758–64.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Bilimoria KY, Balch CM, Wayne JD, et al. Health care system and socioeconomic factors associated with variance in use of sentinel lymph node biopsy for melanoma in the United States. J Clin Oncol. 2009;27(11):1857–63.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Chu BS, Koffi W, Hoehn RS, et al. Improvement and persistent disparities in completion lymph node dissection: lessons from the National Cancer Database. J Surg Oncol. 2017;116(8):1176–84.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Cokkinides VE, Geller AC, Jemal A. Trends in melanoma mortality among non-Hispanic whites by educational attainment, 1993–2007. Arch Dermatol. 2012;148(5):587–91.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Imahiyerobo-Ip J, Ip I, Jamal S, et al. Skin cancer awareness in communities of color. J Am Acad Dermatol. 2011;64(1):198–200.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Temoshok L, DiClemente RJ, Sweet DM, et al. Factors related to patient delay in seeking medical attention for cutaneous malignant melanoma. Cancer. 1984;54(12):3048–53.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Hamilton EC, Nguyen HT, Chang YC, et al. Health disparities influence childhood melanoma stage at diagnosis and outcome. J Pediatr. 2016;175:182–7.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Tucker MA, Halpern A, Holly EA, et al. Clinically recognized dysplastic nevi. A central risk factor for cutaneous melanoma. JAMA. 1997;277(18):1439–44.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Gandini S, Sera F, Cattaruzza MS, et al. Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer. 2005;41(1):28–44.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Cho E, Rosner BA, Colditz GA. Risk factors for melanoma by body site. Cancer Epidemiol Biomark Prev. 2005;14(5):1241–4.CrossRefGoogle Scholar
  28. 28.
    Olsen CM, Carroll HJ, Whiteman DC. Estimating the attributable fraction for cancer: a meta-analysis of nevi and melanoma. Cancer Prev Res (Phila). 2010;3(2):233–45.CrossRefGoogle Scholar
  29. 29.
    National Cancer Institute. Genetics of skin cancer (P.D.Q.®). 2018. Available at: Last accessed 6 Mar 2018.
  30. 30.
    Gandini S, Sera F, Cattaruzza MS, et al. Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer. 2005;41(14):2040–59.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Byrd-Miles K, Toombs EL, Peck GL. Skin cancer in individuals of African, Asian, Latin-American, and American-Indian descent: differences in incidence, clinical presentation, and survival compared to Caucasians. J Drugs Dermatol. 2007;6(1):10–6.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Hu S, Ma F, Collado-Mesa F, Kirsner RS. UV radiation, latitude, and melanoma in US Hispanics and blacks. Arch Dermatol. 2004;140(7):819–24.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Mahendraraj K, Sidhu K, Lau CS, et al. Malignant melanoma in African-Americans: a population-based clinical outcomes study involving 1106 African-American patients from the surveillance, epidemiology, and end result (SEER) database (1988–2011). Medicine (Baltimore). 2017;96(15):e6258.CrossRefGoogle Scholar
  34. 34.
    Pollack LA, Li J, Berkowitz Z, et al. Melanoma survival in the United States, 1992 to 2005. J Am Acad Dermatol. 2011;65(5 Suppl 1):S78–86.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Wheless L, Black J, Alberg AJ. Nonmelanoma skin cancer and the risk of second primary cancers: a systematic review. Cancer Epidemiol Biomark Prev. 2010;19(7):1686–95.CrossRefGoogle Scholar
  36. 36.
    Hübner J, Waldmann A, Eisemann N, et al. Association between risk factors and detection of cutaneous melanoma in the setting of a population-based skin cancer screening. Eur J Cancer Prev. 2018;27(6):563–9.Google Scholar
  37. 37.
    Robbins HA, Clarke CA, Arron ST, et al. Melanoma risk and survival among organ transplant recipients. J Invest Dermatol. 2015;135(11):2657–65.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Omland SH, Gniadecki R, Hædersdal M, et al. Skin cancer risk in hematopoietic stem-cell transplant recipients compared with background population and renal transplant recipients: a population-based cohort study. JAMA Dermatol. 2016;152(2):177–83.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Olsen CM, Knight LL, Green AC. Risk of melanoma in people with HIV/AIDS in the pre- and post-HAART eras: a systematic review and meta-analysis of cohort studies. PLoS One. 2014;9(4):e95096.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Fargnoli MC, Argenziano G, Zalaudek I. High- and low-penetrance cutaneous melanoma susceptibility genes. Expert Rev Anticancer Ther. 2006;6(5):657–70.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Cannon-Albright LA, Meyer LJ, Goldgar DE, et al. Penetrance and expressivity of the chromosome 9p melanoma susceptibility locus (MLM). Cancer Res. 1994;54(23):6041–4.PubMedPubMedCentralGoogle Scholar
  42. 42.
    Bishop JA, Wachsmuth RC, Harland M, et al. Genotype/phenotype and penetrance studies in melanoma families with germline CDKN2A mutations. J Invest Dermatol. 2000;114(1):28–33.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Bishop DT, Demenais F, Goldstein AM, et al. Geographical variation in the penetrance of CDKN2A mutations for melanoma. J Natl Cancer Inst. 2002;94(12):894–903.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Begg CB, Orlow I, Hummer AJ, et al. Lifetime risk of melanoma in CDKN2A mutation carriers in a population-based sample. J Natl Cancer Inst. 2005;97(20):1507–15.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Fargnoli MC, Gandini S, Peris K, et al. MC1R variants increase melanoma risk in families with CDKN2A mutations: a meta-analysis. Eur J Cancer. 2010;46(8):1413–20.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Whiteman DC, Whiteman CA, Green AC. Childhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic studies. Cancer Causes Control. 2001;12:69–82.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Gandini S, Sera F, Cattaruzza MS, et al. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer. 2005;41(1):45–60.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Kulichová D, Dáňová J, Kunte C, et al. Risk factors for malignant melanoma and preventive methods. Cutis. 2014;94(5):241–8.PubMedPubMedCentralGoogle Scholar
  49. 49.
    IARC Working Group on Artificial UV Light and Skin Cancer. The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: a systematic review. Int J Cancer. 2007;120:1116–22.Google Scholar
  50. 50.
    Cust AE, Armstrong BK, Goumas C, et al. Sunbed use during adolescence and early adulthood is associated with increased risk of early-onset melanoma. Int J Cancer. 2011;128(10):2425–35.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Johnson MM, Leachman SA, Aspinwall LG, et al. Skin cancer screening: recommendations for data-driven screening guidelines and a review of the US Preventive Services Task Force controversy. Melanoma Manag. 2017;4(1):13–37.PubMedPubMedCentralCrossRefGoogle Scholar
  52. 52.
    U.S. Preventive Services Task Force. Final update summary: skin cancer: counseling.
  53. 53.
    U.S. Preventive Services Task Force. Final update summary: skin cancer: screening. Available at: Last accessed 4 Jun 2018.
  54. 54.
    Agency for Healthcare Research and Quality. Screening for skin cancer in adults: an updated systematic evidence review for the U.S. Preventive Services Task Force. Available at: Last accessed 4 Jun 2018.
  55. 55.
    American Academy of Family Physicians. Skin cancer – Clinical Preventive Service Recommendation. Available at: Last accessed 4 Jun 2018.
  56. 56.
    American Cancer Society. Cancer Facts & Figures 2015. Available at: Last accessed 4 Jun 2018
  57. 57.
    American Cancer Society. Cancer Facts & Figures 2016. Available at: Last accessed 4 Jun 2018
  58. 58.
    American Academy of Dermatology. AAD statement on USPSTF recommendation on skin cancer screening. 2016. Available at: Last accessed 4 Jun 2018.
  59. 59.
    Skin Cancer Foundation. Prevention guidelines. 2018. Available at: Last accessed 4 Jun 2018.

Copyright information

© Springer Nature Switzerland AG 2021

Authors and Affiliations

  1. 1.Division of DermatologyHarbor-UCLA Medical CenterTorranceUSA
  2. 2.Department of MedicineThe Lundquist InstituteTorranceUSA
  3. 3.David Geffen School of Medicine at UCLALos AngelesUSA
  4. 4.Division of Dermatology, Department of MedicineHarbor-UCLA Medical CenterTorranceUSA

Personalised recommendations