Analysis of the Melanoma Epidemic, Both Apparent and Real

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Abstract
THE INCIDENCE of malignant melanoma of the skin is increasing faster than that of any other cancer in the United States.1 Melanoma incidence has increased from 5.7 cases per 100,000 in 1973 to 12.5 cases per 100,000 in 1994, while melanoma mortality has increased from 1.6 to 2.2 per 100,000 during the same period.2 It is estimated that 41,600 cases of melanoma in the United States will have been diagnosed in 1998 and 7300 people will die of melanoma.3 There is debate as to whether this increase is the result of increased surveillance, a true change in the disease related to an increase in harmful exposures, or a combination of these factors.