Oncology Medical News about late-onset cutaneous malignant melanoma;divergent cancer pathways

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Divergent cancer pathways for early-onset and late-onset cutaneous malignant melanoma
Cancer, 06/29/09

Anderson WF et al. - In a trial to discern the timing and/or age of exposure for cutaneous malignant melanomas (CMM), current results were consistent with a divergent and age-dependent solar hypothesis for CMM. Early-onset melanomas may represent gene-sun exposure interactions that occur early in life among susceptible individuals. Late-onset melanomas may reflect accumulated, lifelong sun exposure in comparatively less susceptible individuals.

Methods

Effect of aging on CMM incidence were systematically examined in data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.
Standard descriptive epidemiology was supplemented with mathematical models.
Impact of advancing age on CMM incidence was assessed by sex, histopathologic classification (superficial spreading melanoma [SSM] or lentigo maligna melanoma [LMM]), and anatomic site (face, head, and neck [FHN] or lower extremity [LE]).

Results

Sex, histopathology, and anatomic site were age-specific effect modifiers for CMM that indicated divergent (bimodal) early-onset and late-onset cancer pathways.
Early-onset melanomas were associated predominantly with women, SSM, and LE.
Late-onset melanomas were correlated with men, LMM, and FHN.
Early- and late-onset melanoma populations were confirmed with age-period-cohort models that were adjusted for period and cohort effects.
2-component mixture models also fit the data better than a single cancer population.

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