Among White Adolescents and Young Adults with Melanoma, Males Have Higher Mortality Than Females


Key Points

  • Adolescent and young adult males accounted for fewer overall melanoma cases (39.8%) than females, but they comprised 63.6% of the melanoma-specific deaths.
  • Males with more favorable tumor characteristics, such as thinner melanomas and lower extremity tumors, were still more likely to die of melanoma than their female counterparts
  • The results support a biologic explanation for male survival disadvantage rather than a purely behavioral one.

Melanoma is the third most common cancer among adolescents and young adults, but few studies have explored the survival differences by sex in this population. A new study published in JAMA Dermatology sought to determine whether long-term survival varied between white male and female adolescents and young adults with melanoma (aged 15 to 39 years at diagnosis) in the United States. According to the report, non-Hispanic white males have a higher mortality than females.

“Focusing on sex disparities in survival among younger individuals may provide further evidence of biological rather than behavioral factors that affect melanoma outcome,” wrote study author Christina S. Gamba, MD, of the Stanford University Medical Center, California, and colleagues.

Study Details

The study included 26,107 non-Hispanic white adolescents and young adults with a primary invasive melanoma of the skin diagnosed from January 1989 through December 2009 and reported to the Surveillance, Epidemiology, and End Results (SEER) network. There was an average follow-up of 7.5 years. Researchers identified 1,561 melanoma-specific deaths in the study population.

Adolescent and young adult males accounted for fewer overall melanoma cases (39.8%) than females, but they comprised 63.6% of the melanoma-specific deaths. According to the results, this population was also “55% more likely to die of melanoma than age-matched females after adjustment for tumor thickness, histologic subtype, presence and extent of metastasis, and anatomical location” (hazard ratio [HR] = 1.55, 95% confidence interval = 1.39–1.73).

Even those males with thin melanomas (≤ 1.00 mm), a more favorable tumor characteristic, were twice as likely to die as age-matched females (HR = 1.95, 95% CI = 1.56–2.42). In addition, although lower extremity tumors are generally associated with better outcomes, males in this study were 67% more likely to die of lower extremity melanomas than their female counterparts.

Need for Heightened Awareness

Researchers suggest that continued public health efforts are needed to raise awareness of the outcome of melanoma in young men.

“This alarming difference in the outcome highlights the urgent need for both behavioral interventions to promote early detection strategies in young men and further investigation of the biological basis for the sex disparity in melanoma survival,” the study concluded.

Dr. Gamba was supported by a Stanford Medical Scholars Fellowship. The study authors reported no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.