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Melanoma
Melanoma:
Risk Factors
A person may have an increased risk of melanoma if he or she:
Is an adult. The risk of melanoma increases with age.
The risk of developing melanoma is 88 times greater after age 15. Melanoma among children
is extremely rare.
Has a changed or persistently changing mole. Melanoma
often develops in an existing mole of any size that changes in color, shape, thickness,
area, or sensation. Bleeding, pain, and ulceration usually are late signs that a mole has
become melanoma. One percent of melanomas lack pigmentation and may appear as pink or red
nodules. Not all changes in a mole, however, indicate melanoma.
Has one or more large or irregularly pigmented skin growths.
This category includes:
prominent moles -- those the size of pencil erasers (about 4 millimeters
in diameter) or larger
dysplastic moles -- large, unevenly colored moles that have fuzzy or
irregular borders and a flat component
lentigo malignas -- precancerous brown "shoe polish stains" on
sun-damaged skin; these are particularly prevalent in the elderly
other atypical pigmented skin growths
Congenital moles. Congenital moles are moles that are
present at birth. Small congenital moles occur in 1 percent of newborns. Infants born with
a small congenital mole have an estimated 5 percent risk of developing melanoma by age 60.
Giant congenital moles are more infrequent -- only one in 500,000 newborns has one. The
lifetime melanoma risk for a person with a giant congenital mole is approximately 10
percent.
Is light skinned. The incidence of melanoma among
whites in the United States is approximately 12 times greater than that among nonwhites.
Among nonwhites, melanoma often appears on the palms of the hands, soles of the feet, and
mucous membranes; in nail beds; and at the site of a congenital, atypical, or changing
pigmented skin growth.
Is sensitive to the sun. The tendency to burn easily
and tan poorly -- regardless of skin color -- is associated with a threefold increase in
the risk of melanoma.
Has experienced excessive sun exposure. Excessive sun
exposure, particularly during childhood, is associated with a threefold increase in
melanoma risk. The relationship between sun exposure and melanoma is not as clear as it is
for nonmelanoma skin cancer. Sun sensitivity and excessive sun exposure may be responsible
for bringing out the trait that causes atypical moles in genetically predisposed people,
or sun exposure may cause potentially precancerous moles to become cancerous. Excessive
sun exposure often occurs during recreational activities.
Has a history of melanoma. People who have had one
melanoma have a ninefold increase in the risk of developing a second primary melanoma. A
past melanoma patient should have a thorough skin exam at least yearly, either from a
doctor or from someone familiar with skin-screening procedures.
Has parents, brothers, sisters, or children with a history of
melanoma. The risk of melanoma increases eightfold if a person has a relative in
the immediate family who has had melanoma. Blood relatives of people who have had melanoma
should be examined regularly for atypical moles and early-stage melanoma.
Has a suppressed immune system. A person whose immune
system is compromised as a result of disease or immunosuppressive therapy (such as the
therapy that helps prevent organ rejection after transplantation surgery) has a fourfold
increase in melanoma risk.
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