title: Malignant melanoma in the 21st century, part 1: epidemiology, risk factors, screening, prevention, and diagnosis.
abstract: Malignant melanoma is an aggressive, therapy-resistant malignancy of melanocytes. The incidence of melanoma has been steadily increasing worldwide, resulting in an increasing public health problem. Exposure to solar UV radiation, fair skin, dysplastic nevi syndrome, and a family history of melanoma are major risk factors for melanoma development. The interactions between genetic and environmental risk factors that promote melanomagenesis are currently the subject of ongoing research. Avoidance of UV radiation and surveillance of high-risk patients have the potential to reduce the population burden of melanoma. Biopsies of the primary tumor and sampling of draining lymph nodes are required for optimal diagnosis and staging. Several clinically relevant pathologic subtypes have been identified and need to be recognized. Therapy for early disease is predominantly surgical, with a minor benefit noted with the use of adjuvant therapy. Management of systemic melanoma is a challenge because of a paucity of active treatment modalities. In the first part of this 2-part review, we discuss epidemiology, risk factors, screening, prevention, and diagnosis of malignant melanoma. Part 2 (which will appear in the April 2007 issue) will review melanoma staging, prognosis, and treatment.
authors.affiliation: Division of Hematology, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905, USA.
authors.forename: Svetomir N
authors.initials: SN
authors.lastname: Markovic
authors.forename: Lori A
authors.initials: LA
authors.lastname: Erickson
authors.forename: Ravi D
authors.initials: RD
authors.lastname: Rao
authors.forename: Roger H
authors.initials: RH
authors.lastname: Weenig
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
authors.forename: Aditya
authors.initials: A
authors.lastname: Bardia
authors.forename: Celine M
authors.initials: CM
authors.lastname: Vachon
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.forename: Robert R
authors.initials: RR
authors.lastname: McWilliams
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hand
authors.forename: Susan D
authors.initials: SD
authors.lastname: Laman
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kottschade
authors.forename: William J
authors.initials: WJ
authors.lastname: Maples
authors.forename: Mark R
authors.initials: MR
authors.lastname: Pittelkow
authors.forename: Jose S
authors.initials: JS
authors.lastname: Pulido
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Cameron
authors.forename: Edward T
authors.initials: ET
authors.lastname: Creagan
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control