title: Trends in the diagnosis and clinical features of melanoma in situ (MIS) in US men and women: A prospective, observational study.
abstract: BACKGROUND
  The incidence of melanoma in situ (MIS) is increasing, but little is known about its clinical and epidemiologic features.
  
  
  OBJECTIVE
  We sought to determine trends in diagnosis and clinical features of MIS.
  
  
  METHODS
  Incident cases of melanoma were collected prospectively from the Nurses' Health Study (1976-2010) and Health Professionals Follow-up Study (1986-2010).
  
  
  RESULTS
  MIS incidence increased from 2 to 42 per 100,000 person-year among women, and from 11 to 73 per 100,000 person-year among men, exceeding the rate of increase of invasive melanomas. Melanoma mortality initially increased during the follow-up period then plateaued. Men were more likely than women to develop in situ melanomas on the upper half of the body (P < .001). Invasive melanomas were diagnosed at a younger age than MIS (P < .001), and were more likely to be found on the lower extremities than MIS (P < .001).
  
  
  CONCLUSIONS
  This is a strictly descriptive study without examination into mechanisms.
  
  
  CONCLUSIONS
  We found epidemiologic and clinical differences for in situ and invasive melanomas, which support further examination into the variations in etiologic pathways. The lack of improvement in mortality despite the increase in detection of in situ relative to invasive lesions further highlights the need to improve invasive melanoma-specific clinical screening features.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: wei.erin@gmail.com.
authors.forename: Erin X
authors.initials: EX
authors.lastname: Wei
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island.
authors.forename: Abrar A
authors.initials: AA
authors.lastname: Qureshi
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana.
authors.forename: Jiali
authors.initials: J
authors.lastname: Han
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Tricia Y
authors.initials: TY
authors.lastname: Li
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island.
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Cho
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Lin
authors.affiliation: Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island.
authors.forename: Wen-Qing
authors.initials: WQ
authors.lastname: Li
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000453:epidemiology / Q000473:pathology; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D014481:United States / Q000453:epidemiology; D000096142:Cutaneous Malignant Melanoma
keywords: age; anatomic sites; epidemiology; gender; incidence; invasive malignant melanoma; lentigo maligna; melanoma; melanoma in situ; melanoma screening; occupational cohorts