Jennifer M. Gardner, MD Clinical Assistant Professor of Dermatology University of Washington School of Medicine

Sun Protection Rising? Melanoma Incidence Decreasing in Young Adults Interview with:

Jennifer M. Gardner, MD Clinical Assistant Professor of Dermatology University of Washington School of Medicine

Dr. Gardner

Jennifer M. Gardner, MD
Clinical Assistant Professor of Dermatology
University of Washington School of Medicine What is the background for this study?

Response: This study looked at age-specific differences of melanoma incidence in the United States. It was an observational study looking at population-based registry data extracted from the combined National Program of Cancer Registries-Surveillance Epidemiology and End Results United States Cancer Statistics (NPCR-SEER) database.

The overall take home message from this study is that though melanoma incidence has continued to climb in the past decade for both men and women, most of the increase is seen in adults greater than age 40 years of age.  In contrast, melanoma incidence decreased in adolescents (ages 10-19 years of age) and young adults (ages 20-29) after peaking around 2004-2005.

Melanoma is more common in males in older individuals (older than 50 years of age) but in younger individuals (<50 years of age), melanoma is more common in females.  According to a recently published JAMA-Otolaryngology paper by Bray and colleagues, there may be a subset of younger individuals where males are at a higher risk than females in regard to head and neck melanoma, and after that study was published we noted this to be true in our numbers, as well (we didn’t publish this in our study), further identifying a possibly “at risk” demographic within the younger age groups in addition to young women. What are the main findings?

Response: Based on how our study was conducted, we do NOT know why these trends are occurring, however, we hypothesize as a plausible explanation that public health campaigns and messaging aimed at promoting sun protection in childhood may have an impact on decreasing melanoma incidence in adolescents and young adults.  We know that early childhood sunburns and extensive ultraviolet (UV) light exposure are risk factors for developing melanoma later in life, so it may be that these public health interventions have not, yet impacted or reversed melanoma incidence in those older than 40 years of age given the timing of when they were implemented but are showing an impact in younger age cohorts.

It may be that older individuals adopted uv-protective behaviors later in life and we have yet to see the impact on this change, however, and we still strongly support uv-protection throughout one’s lifetime to minimize the risk of developing skin cancer, including melanoma.  We hope that we will continue to see a durable trend in lowered melanoma incidence for younger individuals, and it will be interesting to study whether the current adolescent and young adult groups continue to have a lower incidence of melanoma over time as they get older.  Future research looking at specific prevention interventions on the impact of melanoma incidence would also be interesting and important to study. What should readers take away from your report? 

Response: We believe this is a positive and validating message that public health campaigns focused on minimizing ultraviolet light exposure, whether from the sun or from artificial sources, such as indoor tanning beds, may be important and effective at lowering melanoma incidence, and we believe the results of this study could support continued and increased prevention efforts in the future. For individuals, starting in childhood and continuing prevention efforts over the course of one’s lifetime by utilizing sun-protective clothing, broad-brimmed hats, broad-spectrum SPF 30+ sunscreen, wearing uv-protective sunglasses, use of shade and avoidance of tanning beds is a way to help decrease risk of melanoma and other skin cancers.  For healthcare providers, parents, caregivers, teachers, etc. continuing to promote and enforce uv-protection during early childhood may be showing a positive impact already, and continued efforts could truly make a difference.

For older individuals, it is important to understand melanoma incidence continues to rise, and early detection strategies, in addition to continued prevention efforts, are very important: monitor skin for new, changing, or non-healing lesions and get any suspicious skin lesions checked by a board-certified dermatologist for early diagnosis and treatment.  There have been incredible breakthroughs in the treatment of advanced melanoma, and we believe this study could show the positive impact and power of prevention – both tactics are needed to combat this potentially devastating disease. What recommendations do you have for future research as a result of this work? 

Disclosures are listed for each author in fine print at the end of the article – let me know if you don’t have a copy of this.  I have no disclosures to report. 


Paulson KG, Gupta D, Kim TS, et al. Age-Specific Incidence of Melanoma in the United States. JAMA Dermatol. Published online November 13, 2019. doi:


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Last Updated on November 17, 2019 by Marie Benz MD FAAD