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. 2019 Jun;6(2):112-118.
doi: 10.1007/s40471-019-00192-7. Epub 2019 May 31.

Sex Differences in Melanoma

Matthew Robert Schwartz  1 , Li Luo  2 , Marianne Berwick  3
Affiliations

Sex Differences in Melanoma

Matthew Robert Schwartz et al. Curr Epidemiol Rep. 2019 Jun.

Abstract

Purpose of review: The goal of this review has been to elucidate the sex differences in cancer incidence and mortality in cutaneous melanoma. We have evaluated biological and behavioral research to determine where the critical questions exist.

Recent findings: The most recent findings, through 2015, are exploratory in nature but seem to indicate that the differences are more likely due to biological variations rather than behavioral. While behavioral studies do show that women are more likely than men to seek health care and practice healthy behaviors, these differences are not sufficiently strong to explain the variation in incidence and mortality in cutaneous melanoma. Evolved differences in the immune systems of females and the role of sex steroid hormones in immunomodulation are two promising avenues for research. Studies in mice demonstrate that the newer immunotherapies are more effective in females and sex steroid hormones, such as estrogen receptor beta are inversely associated with tumor aggressiveness while testosterone increases it.

Summary: Our analysis indicates that biological factors need to be investigated more thoroughly to understand the variation in incidence and mortality in cutaneous melanoma. Such understanding could lead to reducing incidence and mortality for both males and females (male incidence is 27.4 per 100,000; female 16.8 per 100,000; male mortality is 3.9 per 100,000; female mortality 1.6 per 100,000). It is most likely that behavioral differences between the sexes cannot account for the preponderance of male mortality. In addition to the important role of genetic factors, it is critical to evaluate further additional biological factors and their interactions with genetics and behavior.

Keywords: Melanoma; behavior; biology; genetics; sex; sun exposure.

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Conflict of interest statement

Conflict of Interest Li Luo and Marianne Berwick each declare no potential conflicts of interest.

Figures

Figure 1
Figure 1
Melanoma incidence comparing 2003–2005 to 2013–2015 among whites (including Hispanics) by age and sex. From SEER.
See this image and copyright information in PMC

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