TOPLINE

In young adults with cutaneous melanoma, self-detection and male sex were independently associated with tumour thickness greater than 2 mm. Men experienced higher metastatic progression and melanoma-related mortality than women, with a median of 29.15 years of life lost among melanoma-related deaths.

METHODOLOGY

• Researchers conducted a retrospective cohort study of 316 patients aged 18-44 years with histologically confirmed primary cutaneous melanoma between January 1993 and December 2022. Of these, 177 (56%) were women (mean age at diagnosis, 35.9 years) and 139 (44%) were men (mean age at diagnosis, 35.5 years).
• Melanomas were self-detected, detected by relatives or friends, or detected by healthcare professionals; reasons for consultation were recorded for self-detected cases.
• Outcomes included Breslow thickness greater than 2 mm; metastasis; melanoma-related death; survival; and years of life lost, calculated as the difference between age at death and sex-specific life expectancy.
• The researchers also assessed factors associated with thick melanoma, adjusting for age, sex, detection source, and anatomic site. The median follow-up duration was 142 months.

TAKEAWAY

• Self-detected melanomas were more frequently thick (> 2 mm) than those detected by relatives or friends or by healthcare professionals (P = .003), with the highest proportion of thick melanomas observed among men with self-detected tumours.
• Male sex (adjusted odds ratio [aOR], 3.03; P = .001) and self-detection vs healthcare professional detection (aOR, 2.95; P = .008) were independently associated with thick melanoma.
• Among self-detected cases, nodularity (aOR, 11.9) and bleeding (aOR, 9.77) were most strongly associated with thick melanoma, whereas colour change, pruritus, and aesthetic concern showed no independent association.
• Men had higher rates of metastasis (33.1% vs 18.1%; P = .002) and melanoma-related mortality (18.7% vs 11.3%; P = .049) than women, and male sex remained associated with worse melanoma-specific survival in exploratory analysis (hazard ratio, 1.88; P = .039).
• Melanoma-related deaths in this young cohort caused substantial years of life lost, with a median loss of 29.15 years.

IN PRACTICE

"In young adults, melanoma prognosis is strongly influenced by detection patterns, reasons for consultation, and sex differences," the authors wrote. "Targeted strategies promoting earlier professional evaluation — especially in young men — may reduce advanced-stage presentations and prevent substantial years of life lost," they concluded.

SOURCE

The study was led by Belén Rodríguez-Sánchez, Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. It was published online on August 13, 2026, in the International Journal of Dermatology.

LIMITATIONS

The study had a single-centre and retrospective design, which may have limited generalisability and may have introduced misclassification. The number of melanoma-related deaths was relatively small, and long enrolment between 1993 and 2022 may have introduced differences across treatment eras.

DISCLOSURES

The authors did not declare any funding information and declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.