Epidemiological, clinical and histological characteristics of melanoma in young adults: a 30-year retrospective study (1993-2022).
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BACKGROUND: Melanoma in young adults significantly impacts the survival of individuals in this age group. There are few studies that analyse melanoma characteristics in young patients. OBJECTIVES: To describe the epidemiological, clinical and histological characteristics of melanoma in young adults and the temporal trends in these characteristics in recent decades. METHODS: A retrospective observational study was conducted, involving 399 patients with melanoma aged 18-44 years, over a 30-year period (1993-2022). Patients were divided into two groups based on their date of diagnosis (period 1, 1993-2007; period 2, 2008-2022). RESULTS: Age at diagnosis was higher in period 2 than period 1 (34.3 vs. 36.7 years; P < 0.001). Over time, there was a reduction in median thickness (1.0 vs. 0.68 mm; P = 0.01), a rise in melanomas located on the head and neck [n = 15/230 (6.5%) vs. n = 25/169 (14.8%)] and extremities [n = 97/230 (42.2%) vs. n = 76/169 (45.0%)], and a decrease in melanomas on the trunk [n = 118/230 (51.3%) vs. n = 68/169 (40.2%); P = 0.009]. There was also an increase in lentigo maligna [n = 5/230 (2.3%) vs. n = 5/169 (3.0%)] and superficial spreading melanomas [n = 176/230 (76.5%) vs. n = 142/169 (84.0%)], along with a reduction in nodular types [n = 37/230 (16.1%) vs. n = 10/169 (5.9%); P = 0.01]. In comparison with men, women had a higher prevalence of limb melanoma [n = 125/222 (56.3%) vs. n = 48/177 (27.1%); P < 0.001] and family history of melanoma [n = 26/222 (11.7%) vs. n = 9/177 (5.1%); P = 0.02], thinner melanomas (0.69 vs. 1.10 mm; P = 0.001) and a better prognosis [n = 32/222 (14.4%) vs. n = 37/169 (20.9%) deaths; P = 0.01]. CONCLUSIONS: Melanoma diagnoses in young adults are occurring at progressively advanced ages, with a rise in melanomas situated on the head and extremities and in histological types linked to prolonged sun exposure. Strategies such as minimizing sun exposure from a young age and encouraging self-examination could lead to improved survival rates.