Pediatric Melanoma Cases Rising, Difficult to Diagnose
The number of children diagnosed with melanoma, the most serious form of skin cancer, is rising about 2 percent each year, and the disease is escaping the notice of many pediatricians who do not expect to see it in their young patients, according to a new study published in the journal Pediatrics. More from ABC News:
Melanoma makes up 5 percent of skin cancer diagnosis but a majority of skin cancer deaths.
In 2013, the American Cancer Society estimated, 76,690 new melanomas will be diagnosed and 9,480 people are expected to die from the disease.
Children make up a tiny fraction of these cases, but a study recently published in the journal Pediatrics found that cases of pediatric melanoma are increasing. Between 1973 and 2009, the study found, cases of pediatric skin cancer rose, on average, 2 percent each year.
Melanoma is also the second most common form of cancer for adolescents and young adults between 15 and 29 years old, according to a 2007 study from the National Cancer Foundation.
Unfortunately, pediatric melanoma can be very difficult to diagnose because the warning signs are often very different than those for adult melanoma. In addition, experts say, testing biopsies in a pathology lab can be inconclusive and occasionally these cancers are only definitively diagnosed after they’ve grown or spread.
A major factor in surviving a cancer diagnosis is early detection, but the early signs of pediatric melanoma often masquerade as inconsequential skin problems….
….Dr. Ashfaq Marghoob, director of Memorial Sloan-Kettering’s regional skin cancer clinic in Hauppauge, N.Y., and spokesman for the Skin Cancer Foundation, said melanoma presents very differently in children versus adults.
“You’re asking these doctors to look for zebras,” said Marghoob. “If you usually see horses you’re not looking for zebras. Their mind is not in tune with looking for these melanomas. The morphology of melanoma in kids is different from adults.”
A 2011 study presented at the Pediatric Dermatology Annual Meeting found that 60 percent of children between the ages of 0 and 10 in the study with melanoma did not meet the common melanoma-detection criteria. The criteria is broken down by the “ABCDE warning signs,” which stands for Asymmetry, Border irregularity, Color variation and Diameter over six millimeters, and Evolution of the lesion.
For children between the ages of 10 and 20, approximately 40 percent did not strictly meet the ABCDE criteria.
Instead, many children in the study had tumors that were symmetrical and amelanosis (lacking pigment). The differences were so significant that the study’s authors proposed creating alternative ABCD criteria for pediatric patients, where A is for amelanosis, B for bumps or bleeding, C for uniform Color, and D for various Diameters or de novo (or new) Development.
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