International media coverage of a letter published July 10 in the Journal of Investigative Dermatology inaccurately portrayed melanoma incidence trends among women and men and many of the reports, without foundation, suggested that indoor tanning was responsible for increases in reported melanoma incidence among young women.

“Put simply, the report was false. The authors appeared more interested in making a political statement than in accurately reporting data,” Smart Tan Network Vice President Joseph Levy said. “The statements surrounding their letter made many inferences that are in no way supported by data, ignore conflicting and confounding information and give a false impression about melanoma that could contribute to public misunderstanding.”

Levy, who was hired by Smart Tan in 1992 to analyze skin cancer research, gave a presentation in 2004 to the American Society for Photobiology on the same melanoma data reviewed in the July 10 JID letter. “The U.S. government’s own data show strongly that melanoma incidence and mortality are skyrocketing in men over age 50, but mortality has leveled off and even declined among younger women,” Levy said. “In Canada, both incidence and mortality rates for younger women are declining — not increasing.”

Despite those facts, a group of researchers from National Institutes of Health published last week that melanoma incidence in young women has increased 50 percent since 1980. NIH doctors Mark Purdue, Laura Freeman, William Anderson and Margaret Tucker signed the letter.

“They did not mention that, in that same time period, melanoma incidence in men over 50 increased nearly 300 percent — six times faster than in young women,” Levy said. “That’s a pretty glaring omission. Melanoma is skyrocketing in older men, and yet this group writes a letter that suggests it is increasing in young women without mentioning men. That’s completely irresponsible.”

Indeed, according to NCI’s web site, the median age at diagnosis for melanoma of the skin is 59 years of age. Less than 1 percent of all melanomas are diagnosed under age 20.

“The doctors didn’t point that out in their report either,” Levy said. “And their statements in the press led people to believe that melanoma is increasing in young women but not in older men, which is completely false.”

The doctors also obscured the importance of confounding information:

• They reported that melanoma incidence in teen-age girls increased from around 9-cases-per-100,000 to about 13.9-per-100,000 in the past 25 years — up about 50 percent. But that’s just REPORTED INCIDENCE (not necessarily REAL incidence — REPORTED incidence) data. What has affected incidence data in that time?
• There are 85 percent more dermatologists per capita in the United States. That would increase reported incidence without increasing REAL incidence. Many papers have been written on this.
• Young women are the most likely to visit dermatologists, whose business has become more-and-more cosmetic in recent years. That would account for an increase in diagnosis in that group.
• American Academy of Dermatology representatives have told FDA that dermatologists never used to routinely report melanoma incidence into cancer registries before the mid 1990s. Because they are reporting cases now that would artificially create the sense of an increase.
• There is conflicting information. Mortality data have NOT increased in this age group. And mortality data are more reliable figures — not apples-to-oranges comparisons as incidence data can be.
• Both incidence and mortality for this age group have DECLINED in Canada in the same time period — a divergent outcome.

“And yet the authors obscured and ignored this confounding information. They let the press publish stories saying that melanoma incidence wasn’t increasing in men while NCI’s data show clearly that melanoma incidence in men over 50 increased from 15 per 100,000 to about 75 per 100,000 in the same time period.”

IN THE MEDIA:

Documenting the inaccurate statements made in the press worldwide from the July 10 JID letter:

“Melanoma rates have risen 50% among young women in the U.S. since 1980, a trend that may be related to an increase in the use of tanning salons and exposure to the sun’s damaging rays, according to a report released Thursday.” — Los Angeles Times report, July 11, 2008, by staff writer Wendy Hansen

“Cases of the deadliest form of skin cancer are increasing among young U.S. women but not men, a dermatology study published Thursday said.” — United Press International, July 10, 2008.

“UV exposure comes from two main sources. The first is worshiping the sun with our leisure time, and the other is tanning salons — and that gets us to the subset of people that were involved in this study.” — Dr. John Glaspy, a professor of medicine at the Jonsson Comprehensive
Cancer Center at UCLA, quoted in The Los Angeles Times, July 11, 2008, by staff writer Wendy Hansen.

“Cases of the deadliest form of skin cancer are soaring among young women in the United States, a trend that some experts say parallels the surge in the million-dollar tanning industry.” — TORSTAR NEWS SERVICE, distributed Canada-wide, July 10, 2008.

“I predict we’ll see a worsening of the situation. We’ll see a spike in melanoma-related deaths due to the increase in the tanning industry.” — Dr. David Hogg, a cancer physician at Princess Margaret Hospital, as quoted in TORSTAR NEWS SERVICE, July 10, 2008.

“For young men, the rate of new melanoma cases rose from 4.7 cases per 100,000 per year in 1973 to 7.7 cases per 100,000 per year in 1980, but it then stopped rising. ‘The reason for the leveling off in melanoma rates among young men is not known,’ Purdue said in an e-mail. ‘This may reflect reductions over time in the amount of sun exposure experienced by young men (public awareness campaigns regarding sun exposure and melanoma were widely launched in the US in the 1980s). However, we really don’t know for sure.'” — The Washington Post, July 11, 2008.