Head and neck melanomas increasing, especially among boys and young men

(Reuters Health) - Although relatively rare, head and neck melanomas have been on the rise in North America, increasing by more than 50% over two decades, researchers report.

The increase in these dangerous skin cancers has been largest among non-Hispanic white boys and young men, according to the study published in JAMA Otolaryngology-Head & Neck Surgery.

“I see the findings as an intersection between medicine and public health,” said senior author Nosayaba Osazuwa-Peters of the Saint Louis University School of Medicine in Missouri. “The literature has always focused on melanoma and females and tanning. Our study is showing that we should not just target young girls.”

Osazuwa-Peters would like to see melanoma awareness campaigns reaching out to hair stylists and barbers because they are often the first to notice “something out of the ordinary” on a client’s scalp.

“We need to empower and equip the people who see the scalp the most,” he said. “They need to know what they are looking at so they don’t immediately think it’s just a weird birthmark. Teaching lay people how to recognize the signs of melanoma in the scalp would be a worthwhile venture.”

Spotting head and neck cancers early is important since they tend to be more lethal than similar cancers on other parts of the body, Osazuwa-Peters said.

To take a closer look at the incidence of head and neck melanomas, Osazuwa-Peters and colleagues turned to the North American Association of Central Cancer Registries. That dataset includes cancers diagnosed in both the U.S. and Canada.

The researchers opted to focus on 12,462 patients aged 0 to 39 years who were diagnosed with head and neck melanomas from 1995 to 2014 in 26 U.S. states and six Canadian provinces. Twenty-four states were left out of the analysis because they were missing data for some years.

The states included in the study were Arizona; California; Colorado; Connecticut; Delaware; Florida; Hawaii; Idaho; Illinois; Iowa; Kentucky; Louisiana; Maine; Michigan; Nebraska, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, Texas, Utah; Washington; West Virginia; Wisconsin and Wyoming. The Canadian provinces were Alberta; British Columbia; Manitoba; New Brunswick; Ontario and Saskatchewan.

Overall, the incidence of head and neck cancers in North America increased by 51.1% between 1995 and 2014. However, between 1995 and 2000, head and neck melanoma incidence increased by 4.68% per year in the U.S., then slowed to 1.15% per year between 2000 and 2014. In Canada, incidence steadily increased by 2.18% per year between 1995 and 2014.

Older age, male gender and non-Hispanic white race/ethnicity were all associated with an increased incidence of head and neck melanoma.

The researchers don’t know why there are more head and neck cancers among boys and men, but they suspect it may be partly related to lack of hair covering the skin of the head and neck. Females probably get some protection from the sun because they are more likely wear their hair long. Males not only tend to wear their hair shorter but also are more likely to experience thinning or going completely bald by the time they are in their late 30s, Osazuwa-Peters said.

Dr. Jason Luke agrees that hair may at least partly explain why head and neck melanomas are more common among men than women.

Overall, the findings suggest that public health messages be updated to target both males and females, said Luke, a melanoma specialist and an associate professor of medicine at UPMC and the University of Pittsburgh.

“We need to talk to all young people about the risk,” Luke said.

SOURCE: and JAMA Otolaryngology-Head & Neck Surgery, online October 3, 2019.