Reagan was diagnosed with the disease in 1996 and began a year-long treatment with interferon, a naturally occurring substance that helps the body fight some cancers. At the end of this treatment, reports indicated that Reagan was in remission. In 2000, physicians determined that the melanoma had recurred and spread, and she began a new course of treatment, according to news reports.

Melanoma, the most dangerous kind of invasive skin cancer, is on the rise in the US, according to results of a study recently reported in the Journal of the National Cancer Institute (Vol. 93, No. 9: 678-683).

"Between 1973 and 1997, the incidence of melanoma (the number of cases per 100,000 people in a population) almost tripled among males, and more than doubled among females," says Ahmedin Jemal, PhD, DVM, a post-doctoral research fellow at the National Institutes of Health (NIH), and an author of the study.

Jemal and colleagues examined records from a huge cancer database from the NCI’s Surveillance, Epidemiology, and End Results (SEER) Program to analyze information on the 60,541 cases of melanoma diagnosed between 1973 and 1997 among white people living in the areas covered by the SEER data. Whites were studied because they are much more likely to develop melanoma than those with darker skin.

The NIH researchers found that in recent years, the incidence rates have increased the most in men 60 and over, while rates among those 50 and younger has begun to level off. Jemal says rates are still rising steeply among older men mainly because melanoma takes a long time to develop, and men now age 60 and older got most of their sun exposure in the 1950s and earlier, before there was much awareness about the need for sun protection.

For women born between 1950 and 1960, the incidence of melanoma has stabilized. However, for women born since 1960, the rate has continued to increase, a finding from the study that had not been expected. Many cancer experts find this trend disturbing.

According to the study, some of this change may be the result of sun-exposure behaviors and attitudes of each generation of males and females during childhood and adulthood. The authors write that from 1986 to 1996, more people had experienced at least one sunburn (30% vs. 39%), which is the most consistently associated sun-exposure finding in patients who develop melanoma. As a result, they conclude that it is likely that the incidence of melanoma will continue to increase for the foreseeable future.

"There is some leveling off of mortality rates (the percentage of people in a population who die of a disease) in some segments of the population — in women, generally — and that’s good," says Allan Halpern, MD, chief of dermatology service at Memorial Sloan Kettering Cancer Center in New York, and vice chair of the American Cancer Society’s (ACS) skin cancer advisory group. "But this study shows the rising incidence of melanoma is quite real, and that’s not good at all," notes Halpern.

"We need to make significant progress among groups in which there hasn’t yet been a leveling off of mortality rates, especially older men, and we need to significantly reduce mortality rates and incidence rates in the rest of the population as well," Halpern says.

Halpern says practical steps can lower the risk of getting melanoma.

"First, avoid any intentional sun exposure. Attempting to ‘work on a tan’ whether by sun or tanning lights, is just courting disaster," Halpern says.

"When you’re outdoors, try to stay in a more shaded environment," Halpern advises. "Keep a shirt on, with a wide-brimmed hat shading your face, nose, ears, and post of your neck. And use sunscreen, but as part of a comprehensive sun-protection strategy on those parts of the body not protected by appropriate clothing — not as a substitute," he cautions.

"Know the  ABCD rule for spotting melanoma early, and make sure you and your health care provider include a skin checkup as part of your regular health maintenance," emphasizes Halpern. "Found early, melanoma is 100% treatable."

"When more people begin taking these actions, we’ll begin to see fewer melanoma cases and fewer deaths from this very avoidable cancer," Halpern says.