Tuesday, September 6, 2011

Melanoma epidemic? You be the judge

The rising incidence of melanoma is alarming, but can it correctly be called an epidemic? I’ve written my share of headlines over the years, so I know the power of a well-chosen word to grab readers’ attention. But epidemic is a word that’s best used with care, given its capacity to at first frighten but ultimately to lull people into complacency with its overuse.
So you be the judge. What do you make of the following information?
The National Cancer Institute has looked at melanoma in women in their late 20s, comparing data from 1994-96 to data from 2004-06. In a decade, the incidence of melanoma in this population increased 42%. For women ages 30 to 34, the number of cases grew 32%. Most dermatologists would attribute this increase directly to indoor tanning, which became popular in the 1990s.
Calling this a statistical aberration is one option, but that term won’t work in a headline. There’s clearly something happening here and if this is not an epidemic, it should still scare the daylights out of anyone pursuing a “prom tan.”
I don’t know the absolute number of cases of melanoma in young women, but it remains relatively small. About 70,000 new cases of melanoma are diagnosed annually overall. While the incidence of melanoma in young women may be “skyrocketing,” to use another favorite of headline writers, it’s still most commonly diagnosed in Caucasian men over the age of 50. Know anyone who fits that description? Our numbers are up too, but not nearly as dramatically.
In epidemiology, an epidemic occurs when new cases of a certain disease, in a given human population and during a given period, substantially exceed what’s expected based on recent experience. The disease is not required to be communicable. By this strict scientific definition, it’s reasonable to say that melanoma has become an epidemic, at least among younger women.
Speaking at a summer meeting of the American Academy of Dermatologists, Dr. Darrell Rigel of New York University Medical Center told his colleagues: “Twenty years ago, it was rare to see a woman in her 20s with melanoma, and we also did not see a lot among women in their 30s. Now, we commonly see cases in women in their 20s, and every one of them has a tanning history.”
Fortunately, melanoma is highly curable if caught before it spreads to the lymph nodes. “Cure,” however, typically means surgery. Better to never indulge in indoor tanning in the first place. The ultraviolent radiation that’s used by tanning beds is a carcinogen that can mutate the DNA in skin cells and lead to cancer. Like the damage that cigarette smoking does to your lungs, you can’t see this happening. Melanoma caused by UV exposure doesn’t show up until years after the damage has been done.

There’s absolutely nothing good to be said about young women being diagnosed with melanoma, however minimal their disease may be. Epidemic or not, this trend can be reversed, if melanoma's association with  indoor tanning beds holds up statistically. The California Senate has this week approved and sent to Gov. Jerry Brown a bill that would ban children under 18 from using indoor tanning beds. That’s a start. Recreational tanning with UV radiation is stupidly reckless and with education and some political will, it’s an industry that can be put out of business. And that, I believe, would put an end to this particular epidemic.

No comments: