Women, Men and Melanomas

In the past, when I have performed a skin cancer screening on a patient, I have always told the patient that a melanoma in a woman is more likely to develop on the lower legs while a melanoma in a man is more likely to develop in a man on the trunk. Unbeknownst to me, my information was based on a study that was done in the over 40 years ago.

A new study (Clark LN, Shin DB, et al. Association Between the Anatomic Distribution of Melanoma and Sex. J Am Acad Dermatol 2007; 56 (May5):768-773) now shows that over 30 years later this difference in anatomic distribution for melanoma between men and women no longer holds true. This study suggests males are now as likely as females to develop melanomas on their lower legs and females were as likely as males to acquire melanoma on their upper backs. In fact, the only significant difference in site distribution was that men had a greater frequency of melanoma on the head and neck.

In this study done in 2004, for men 27% of their melanomas were on the head and neck, 43% on the trunk, 13% on the upper extremities, 17% on the lower extremities – for women 10% were on the head and neck, 51% on the trunk, 17% on the upper extremities and 22% on the lower extremities. The authors hypothesize that these changes could have come about by differences in clothing and lifestyle over the years.

So now when we do skin exams whether it is a man or a woman we should always do a head to toe inspection.