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Association between the anatomic distribution of melanoma and sex - 12/08/11

Doi : 10.1016/j.jaad.2006.12.028 
Lily N. Clark, MD a, Daniel B. Shin, BA a, Andrea B. Troxel, ScD b, Shahbaz Khan, MBBS, MPH a, Arthur J. Sober, MD c, Michael E. Ming, MD, MSCE a, b,
a From the Departments of Dermatology 
b Biostatistics and Epidemiology at the University of Pennsylvania 
c Harvard Medical School 

Reprint requests: Michael E. Ming, MD, MSCE, Department of Dermatology, University of Pennsylvania, 2 Maloney Bldg, 3600 Spruce St, Philadelphia, PA 19104.

Philadelphia, Pennsylvania, and Boston, Massachusetts

Abstract

Background

Anatomic distribution of melanoma, thought to be different between men and women, has not been studied in the United States since the 1970s, although lifestyle and clothing habits have changed since then.

Objective

To determine whether the anatomic distribution of melanoma varied between men and women at our institution in 2004 and in the 1970s, and to assess whether the anatomic distribution has changed over time.

Methods

We recorded the body location of initial primary cutaneous melanomas and assessed other variables of interest for 152 patients seen in our clinic in 2004 and in 397 patients seen between 1972 and 1977. Logistic regression was used for analysis.

Results

For the 2004 patients, males had an increased relative risk compared to females of developing a melanoma on their head and neck (relative risk ratio [RRR] = 3.33; P = .01). For the 1970s patients, this difference was not found, but males in the 1970s had higher odds of developing melanoma on their upper back, chest, and abdomen, while females in the 1970s had higher odds of developing melanoma on the upper extremity and lower extremity, particularly the lower legs and feet. Examining differences over time, we found that women in 2004 had a decreased relative risk of developing a melanoma on the lower extremities as opposed to the trunk as compared to the 1970s (RRR = 0.42; P < .01). We also found that women had increased odds of developing a melanoma on the chest in 2004 compared to the 1970s (OR = 2.65; P = .04), while men had increased odds of developing a melanoma on their lower legs in 2004 compared to the 1970s (OR = 3.18; P = .02).

Limitations

The study was performed at a single academic center and the results may not generalize to all melanoma populations. There may be important unexamined confounders.

Conclusions

There were significant differences between men and women in the anatomic distribution of melanoma in 2004 patients and in 1970s patients, but the nature of those differences changed over time.

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 Funding sources: None. At the time of this research, Dr Ming was supported by a Career Development Award from the Dermatology Foundation.
Conflicts of interest: None declared.
Presented in part as an oral presentation at the Annual Meeting of the International Dermato-Epidemiology Association during the 66th Annual Meeting of the Society for Investigative Dermatology, St Louis, Missouri, May 5, 2005.


© 2007  American Academy of Dermatology, Inc.. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 56 - N° 5

P. 768-773 - mai 2007 Regresar al número
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