Epidemiological, clinical and histological characteristics of melanoma in young adults: a 30-year retrospective study (1993-2022).

BACKGROUND

Melanoma in young adults significantly impacts the survival of individuals in this age group. There are few studies that analyse melanoma characteristics in young patients.

OBJECTIVES

To describe the epidemiological, clinical and histological characteristics of melanoma in young adults and the temporal trends in these characteristics in recent decades.

METHODS

A retrospective observational study was conducted, involving 399 patients with melanoma aged 18-44 years, over a 30-year period (1993-2022). Patients were divided into two groups based on their date of diagnosis (period 1, 1993-2007; period 2, 2008-2022).

RESULTS

Age at diagnosis was higher in period 2 than period 1 (34.3 vs. 36.7 years; P < 0.001). Over time, there was a reduction in median thickness (1.0 vs. 0.68 mm; P = 0.01), a rise in melanomas located on the head and neck [n = 15/230 (6.5%) vs. n = 25/169 (14.8%)] and extremities [n = 97/230 (42.2%) vs. n = 76/169 (45.0%)], and a decrease in melanomas on the trunk [n = 118/230 (51.3%) vs. n = 68/169 (40.2%); P = 0.009]. There was also an increase in lentigo maligna [n = 5/230 (2.3%) vs. n = 5/169 (3.0%)] and superficial spreading melanomas [n = 176/230 (76.5%) vs. n = 142/169 (84.0%)], along with a reduction in nodular types [n = 37/230 (16.1%) vs. n = 10/169 (5.9%); P = 0.01]. In comparison with men, women had a higher prevalence of limb melanoma [n = 125/222 (56.3%) vs. n = 48/177 (27.1%); P < 0.001] and family history of melanoma [n = 26/222 (11.7%) vs. n = 9/177 (5.1%); P = 0.02], thinner melanomas (0.69 vs. 1.10 mm; P = 0.001) and a better prognosis [n = 32/222 (14.4%) vs. n = 37/169 (20.9%) deaths; P = 0.01].

CONCLUSIONS

Melanoma diagnoses in young adults are occurring at progressively advanced ages, with a rise in melanomas situated on the head and extremities and in histological types linked to prolonged sun exposure. Strategies such as minimizing sun exposure from a young age and encouraging self-examination could lead to improved survival rates.