The changing face of malignant melanoma.

Background And Objectives: There is currently an epidemic of malignant melanoma occurring in the United States. At the same time there has been a heightened awareness for early detection of melanoma in the professional ranks as well as in the lay population. A database review was performed to investigate the changing patterns of melanoma presentation during a 2 decade time period in the State of Florida.

Methods: This report is based on data collected in a prospective fashion from three institutions that shared a single melanoma database initially established in 1987. Four 5-year time periods were arbitrarily selected for the study: 1989-1993, 1994-1998, 1999-2003, and 2004-2008. Patients were grouped by their date of initial diagnosis.

Results: A total of 7,580 patients were registered in the database during the study intervals. Multiple group comparisons by Chi-Square analysis showed that there were significant differences among the four groups in tumor thickness at diagnosis, stage of disease at diagnosis and disease-free survival (DFS). The DFS rate for all patients diagnosed with melanoma has progressively improved over the last 20 years (P < 0.0001).

Conclusions: Even though there is an epidemic of malignant melanoma occurring in the United States, it appears that patients are being diagnosed earlier with thinner lesions that are capable of being cured with simple surgical techniques.