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Rising Incidence and Molecular Chara...

Brewer, Jerry D.

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Rising Incidence and Molecular Characteristics of Malignant Melanoma; a Population-Based Approach.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Rising Incidence and Molecular Characteristics of Malignant Melanoma; a Population-Based Approach./
Author:	Brewer, Jerry D.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2017,
Description:	86 p.
Notes:	Source: Masters Abstracts International, Volume: 56-02.
Contained By:	Masters Abstracts International56-02(E).
Subject:	Medicine. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10250970
ISBN:	9781369442854

Rising Incidence and Molecular Characteristics of Malignant Melanoma; a Population-Based Approach.
Brewer, Jerry D.

Rising Incidence and Molecular Characteristics of Malignant Melanoma; a Population-Based Approach. - Ann Arbor : ProQuest Dissertations & Theses, 2017 - 86 p.

Source: Masters Abstracts International, Volume: 56-02.

Thesis (M.BIO.Med.S.)--College of Medicine - Mayo Clinic, 2017.

Rationale.

ISBN: 9781369442854Subjects--Topical Terms:

641104
Medicine.

Rising Incidence and Molecular Characteristics of Malignant Melanoma; a Population-Based Approach.
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100 1 $a Brewer, Jerry D. $3 3353444
245 1 0 $a Rising Incidence and Molecular Characteristics of Malignant Melanoma; a Population-Based Approach.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2017
300 $a 86 p.
500 $a Source: Masters Abstracts International, Volume: 56-02.
500 $a Adviser: Celine M. Vachon.
502 $a Thesis (M.BIO.Med.S.)--College of Medicine - Mayo Clinic, 2017.
520 $a Rationale.
520 $a The objective of this thesis is to determine the age- and sex-specific incidence of melanoma in Olmsted County, MN, in patients aged 18 and older from 1970 through 2009, to look at differences in mortality by age and sex, and to examine the trends of histologic type, location of melanoma and BRAF mutation status differences over time. BRAF mutations occur commonly in melanoma, and typically occur in older patients on chronically sun damaged skin. BRAF mutated melanomas have also been associated with high early life ambient UV exposure, especially between the ages of 0 and 20 years and theoretically could be seen more frequently in younger patients with prior high levels of UV exposure.
520 $a Methods.
520 $a Utilizing the Rochester Epidemiology Project, 1035 individuals were identified as newly diagnosed with melanoma between 1970 and 2009 and residing in Olmsted County. 253 were stage 0 (in situ), 550 were stage IA, 80 were stage IB, 57 were stage II, 18 were stage III, and 47 were stage IV. Of these, 255 individuals were between the ages of 18 and 39, 383 individuals between the ages of 40 and 60, and 397 individuals older than 60. All cases of melanoma were confirmed via pathology reports. Incidence rates per 100,000 person-years were calculated overall and by decade; the population at risk was estimated using Olmsted County census data from 1970, 1980, 1990, and 2000 with linear interpolation for inter-censal years. Overall survival and disease-specific survival were estimated using the Kaplan-Meier method. Associations between patient or melanoma characteristics and death from any cause and death from disease, were assessed using Cox proportional hazards regression models and summarized with hazard ratios and 95% confidence intervals. Available pathology slides for patients between the ages of 18 and 60 were reviewed and confirmed by a single dermatopathologist to confirm the diagnosis of malignant melanoma, and to confirm the histologic type of the melanoma, as well as to confirm that enough tissue was available for subsequent BRAF analyses. The age at diagnosis was compared between BRAF positive versus negative patients using the Wilcoxon rank sum test. BRAF mutated melanomas were compared according to BRAF status by age, sex, and decade, as well as by location, histologic type, and stage (invasive, non-invasive, or advanced).
520 $a Results.
520 $a Over the 4 decades of 1970 to 2009, the incidence of melanoma increased 7 fold over all ages. Specifically, melanoma increased 4 fold in young men, 8 fold in young women, 4.5 fold in middle-aged men, 24 fold in middle-aged women, 11 fold in elderly men, and 4 fold in elderly women. Although the incidence of melanoma increased over time significantly across all age ranges, disease-specific survival also increased across all age ranges. In addition overall survival also increased in individuals with melanoma in Olmsted County from 1970 to 2009. Men were 67% more likely to die from melanoma compared to women. Each 10-year increase in year of diagnosis was associated with a reduced risk of death from melanoma. In-situ forms of melanoma, including lentigo maligna and superficial spreading have increased from 8% to 32% from 1970 to 2009. Other forms of melanoma have either remained stable or even decreased from 1970 to 2009. This trend remained significant for both men and women. Location of melanoma did not significantly change over time in men or women. The number of melanomas that were BRAF positive stayed stable over time from 1970 to 2009. There was also a trend towards less BRAF positive melanomas with increasing age although this was not statistically significant.
520 $a Conclusions.
520 $a Melanoma incidence is rising at a striking rate across all ages, but especially in middle-aged women and elderly men. The reasons for the rise in melanoma is not entirely clear, but sun exposure and life style habits, in addition to tanning bed use over the last 4 decades most likely play a role. Although melanoma is increasing at an astounding rate across all cohorts, the chances of dying from metastatic melanoma decreases with each calendar year in all age ranges. Non-invasive forms of melanoma are rising more than all other forms of melanoma and are mostly likely the reason for the increased survival trend that is seen from 1970 to 2009. This could be due to increased awareness skin cancer in the general population and/or easier access to a dermatologist in recent decades. It does not appear that BRAF mutated melanomas are more frequent in certain ages, or individuals that are younger, or even according to the site of melanoma. Further studies are necessary to determine how BRAF mutated melanomas are associated with UV exposure including tanning bed use. (Abstract shortened by ProQuest.).
590 $a School code: 1542.
650 4 $a Medicine. $3 641104
650 4 $a Health sciences. $3 3168359
650 4 $a Health education. $3 559086
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773 0 $t Masters Abstracts International $g 56-02(E).
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791 $a M.BIO.Med.S.
792 $a 2017
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10250970