The epidemiology, aetiology and prevention of melanoma

Mortality rates have also signifi cantly risen over the last 25 years (Fig. 1.1), but at a much slower pace as tumours < 1 mm in Breslow thickness have a good prognosis. In contrast to incidence, mortality is greater in men, with male deaths outnumbering female deaths almost twofold. The rise in melanoma mortality has been greatest among men aged > 65 years, who present late with thick (> 4 mm in Breslow depth) advanced tumours that have a poor prognosis. Reasons for this include the tendency for melanoma to be located on the back in males where they are hard to see, lack of self-examination and a tendency for not reporting changing moles.