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Trends in Clark Level and Breslow Thickness of Invasive Cutaneous Malignant Melanoma over a 50‐Year Period in Olmsted County/Rochester, MN
Author(s) -
Pierson D.,
Subtil A.,
Pittelkow M.,
Scott C.,
Weenig R.,
Vachon C.
Publication year - 2005
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2005.320fq.x
Subject(s) - breslow thickness , melanoma , incidence (geometry) , medicine , epidemiology , rochester epidemiology project , population , dermatology , surgery , demography , pathology , population based study , cancer , sentinel lymph node , environmental health , physics , cancer research , sociology , breast cancer , optics
Incidence of invasive melanoma is reported to be steadily increasing worldwide. Whether due to an actual increase in disease, or increased surveillance and changes in diagnostic criteria, or both is unknown. The purpose of this study was to analyze Clark Level and Breslow thickness trends in a population‐based sample over five decades. All cases of invasive melanoma, a total of 200, diagnosed from 1985–1999 were identified using the Rochester Epidemiology Project that incorporates medical‐surgical index information for all residents of Rochester/Olmsted County. These findings updated two previous studies of invasive melanoma from 1950–1985, resulting in 296 total cases over the 1950–1999 period. The incidence of Clark level II lesions increased from 0% in 1950–1959 to 51% in 1990–1999, while Clark level V lesions decreased from 38% to 4%. Moreover, the incidence of lesions with Breslow 4 mm decreased from 25% to 7%. These variations were found to be statistically significant (p = <0.01). The decreases in Clark level and Breslow thickness seen in this population‐based sample over the last 5 decades suggests that a significant component of increased invasive melanoma incidence may be explained by increased surveillance and earlier detection.