The Epidemiology of Cutaneous Melanoma in the White and Black African Population Groups in South Africa

Abstract

In this chapter, two South African population groups, White and Black African, are compared with regard to cutaneous melanoma (CM). The incidence of CM in Black Africans is about 10% of that in Whites, explained at least in part by the protection offered by cutaneous melanin. The incidence has probably risen in Whites over the past 40 years but seems to be unchanged in Black Africans. The commonest CM subtype in Whites is superficial spreading; it occurs on various body sites, the most frequent being the trunk in males and the lower leg/hip in women. Most CMs in both male and female Black Africans are found on the lower leg and/or hip with a significant proportion being acral lentiginous melanoma, a subtype rarely seen in Whites. Risk factors including exposure to the sun, trauma, human immunodeficiency virus infection, albinism, age, and genetics are summarized and are likely to differ between the two population groups. The stage of CM at diagnosis tends to be more advanced in Black Africans than in Whites and, similarly, the survival rates are considerably lower in Black Africans. Reasons for the differences in CM between the two population groups are suggested.