A. Borad1, K. Pena1, S. Burjonrappa1 1Robert Wood Johnson – UMDNJ, Pediatric Surgery/Surgery, New Brunswick, NJ, USA
Introduction:
Pediatric melanoma is the most commonly diagnosed skin cancer in children, with the annual incidence recently increasing by an average of 2% each year. UV radiation from excessive sun exposure is an important carcinogenic risk factor, with penetration varying greatly throughout the country. Consequently, an individual’s geographic location may play a role in how much exposure to high UV index rays they receive throughout their lifetime.The objective of this study was to use the Surveillance, Epidemiology, and End Results (SEER) database to study geographic trends in incidence, staging, and mortality of pediatric melanoma between 2009 and 2019 and determine their relation to UV index in the United States (US).
Methods:
A retrospective analysis of pediatric patients from 0 to 19 years in the SEER 22 registries incidence database (17 states) and 17 registries incidence-based mortality database (12 states) was conducted from 2009 to 2019 based on a diagnosis of melanoma of the skin using the International Classification of Childhood Cancer (ICCC) codes for malignant melanoma. Data regarding patient demographics and incidence, staging, and mortality per state was extracted. Incidence data was geographically mapped and mean UV index distribution from www.epa.gov was superimposed.
Results:
Incidence of pediatric melanoma was stratified regionally, with a total of 1665 new cases from 2009-2019. The Northeast had 393 new cases, with 244 (62.1%) localized cases, 55 (14.0%) lymph node-invasive and metastatic (advanced) cases, and 6 (4.1%) cases of mortality. The Midwest had 209 new cases, with 123 (58.9%) localized cases, 29 (13.9%) lymph-node invasive and metastatic cases, and 1/57 (1.8%) case of mortality. The South had 487 new cases, with 224 (46.0%) localized cases, 104 (21.4%) advanced cases, and 8/232 (3.4%) cases of mortality. The West had 576 new cases, with 364 (63.2%) localized cases, 82 (14.2%) advanced cases, and 23/551 (4.2%) cases of mortality. Mean UV index for the month of August ranged from 5-8 in the Northeast and Midwest, 10-13 in the South, and 5-13 in the West from 2006-2020. The regional difference in incidence was not statistically significant. There was a statistically significant increased number of advanced cases in the South as compared to the Northeast (p=0.005), West (p=0.002), and Midwest (p=0.02).
Discussion:
The highest number of new pediatric melanoma cases was seen in the West and South. The highest incidence of lymph node-invasive and metastatic disease was seen in the South. The highest incidence of mortality was seen in the West. The Western and Southern regions of the US have the highest UV index sunrays throughout the year. This suggests that an individual’s geographic location in the US during childhood may play a role in their likelihood of malignant melanoma development, advanced-stage melanoma development, and mortality.
