Malignant melanoma of the skin in Hawaii, 1960-1977.

An analysis was made of the 333 cases of invasive malignant melanoma (MM) of the skin, which were diagnosed among residents of Hawaii from 1960-1977. Caucasians accounted for 265 (79.6%) of the cases. The age-adjusted incidence rate of MM was found to have tripled among both male and female Whites during the study period, while no increase was observed for non-Whites. Among Whites, age-adjusted incidence rates increased for all anatomic sites for both sexes, except for apparently stable rates on the lower extremities of females. Rates were higher for males on the head and neck and trunk and higher for females on the lower extremities. By 1972-77, however, rates on the lower extremities were equal for the sexes. Interestingly, age-adjusted rates for Hawaii-born Whites were found to be much lower than for Caucasian immigrants, particularly among females, where a six-fold difference was observed. Thus, the epidemiology of MM in Hawaii is largely, but not entirely, consistment with the hypothesis that solar exposure is a major risk factor for MM.