Thick melanoma: the problem continues

Background  The incidence of melanoma and its associated mortality has stabilized over the recent years, due in part to efforts directed at better prevention and detection of these lesions. We analysed the trends in the distribution of melanomas, mainly according to their thickness. Methods  Data from the Dermatology Service of ‘Virgen de la Victoria’ University Hospital in Malaga (Spain) showed a total of 459 cases of melanoma between 1990 and 2005, both inclusive. The lesions were stratified according to year of diagnosis (1990–96 and 1997–2005), sex, age (0–49, ≥ 50), thickness (0–0.99, 1.00–1.99, and ≥ 2 mm) and the histological subtype [lentigo maligna melanoma (LMM), superficial spreading melanoma (SSM), nodular melanoma (NM) and acral lentiginous melanoma (ALM)]. Particular attention was given to the distribution of the groups according to thickness. Results  The number of new cases rose by 92% between the two study periods (1990–1996 and 1997–2005). However, the number of new cases of thick melanoma remained almost constant over the two periods, being associated with persons over 50 years of age (65.1% vs. 64.3%), with men having half the cases (48.4% vs. 47%). The proportion of nodular melanomas within the group of thick melanomas was high in both periods (36.5% and 39.3%, respectively). Conclusions  This study shows that despite the large increase in new melanomas, the diagnosis of thick melanomas has remained constant, mainly in persons over the age 50 years, with a relative increase in men. New strategies and education programmes are, therefore, required for the early detection of this type of tumour to reduce its incidence in these patients.