What age group is most commonly affected by melanoma?

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Melanoma Most Commonly Affects Adults with a Median Age of 59-65 Years

The median age at melanoma diagnosis is 59-63 years, though incidence rises exponentially with age and peaks at 65 years, with elderly patients (≥70 years) representing approximately 30-39% of all cases. 1

Age Distribution Patterns

Peak Incidence Age

  • Median age at diagnosis is 59 years according to NCCN guidelines, with the median age at death being 69 years 1
  • The ESMO guidelines report that melanoma incidence peaks at 65 years, though any age can be affected 1
  • Approximately 30-39% of melanoma patients are ≥70 years old at diagnosis 2, 3

Age-Related Risk Progression

  • Melanoma risk increases exponentially with age, yet approximately 50% of melanomas occur in individuals younger than 50 years 4
  • Melanoma is one of the most common cancers in persons under 30 years of age 4
  • Older adults, particularly men over 65, account for about 22% of newly diagnosed melanomas annually and represent the highest-risk demographic 1, 4

Critical Age-Related Differences in Disease Presentation

Elderly Patients (≥70 Years)

  • Higher prevalence of multiple melanomas (>50% in patients >60 years) 5
  • More frequent head and neck melanomas (29-34% vs. 9-20% in younger patients, p<0.001) 2, 3
  • Thicker tumors at presentation: mean Breslow thickness 2.4mm vs. 1.8mm in younger patients (p<0.001) 3
  • Higher proportion of T3/T4 melanomas (37% vs. 20% in younger patients) 2
  • More aggressive histologic subtypes: nodular, lentigo maligna, and acral lentiginous melanomas are overrepresented 2

Younger Patients (<40 Years)

  • Familial melanoma is more common (54.3% in those <40 years) 5
  • Highest nevus counts and density (mean: 139.6 nevi) 5
  • Better prognosis: 5-year relative survival 90-96% vs. 67-89% in elderly 6

Mortality Impact by Age

Melanoma ranks second only to adult leukemia in terms of years of potential life lost per death, reflecting its impact across age groups 1

Age-Specific Mortality Patterns

  • 5-year disease-specific mortality is significantly worse in elderly patients: 16% vs. 8% in younger patients (p=0.004) 3
  • Overall 5-year mortality in elderly: 30% vs. 12% in younger patients (p<0.001) 3
  • Melanoma incidence and mortality continue to rise unabated in older individuals, particularly men over 65, while rates have stabilized in younger Americans 7

Clinical Pitfalls in Age-Related Diagnosis

Delayed Diagnosis in Elderly

  • Diagnosis occurs more frequently in general practice settings rather than dermatology for elderly patients 2
  • Time to definitive excision is longer in older patients 2
  • 16.8% of elderly patients have insufficient excision margins vs. 5.0% in younger patients (p<0.001) 2
  • Sentinel lymph node biopsy is underutilized: performed in only 23.3% of elderly with thick melanomas vs. 41.4% in younger patients (p<0.001) 2

Biological Differences

  • Aging diminishes capacity to repair UV-induced DNA damage, contributing to higher melanoma risk 4
  • Despite thicker tumors, elderly patients have fewer sentinel lymph node metastases (18% vs. 33% in T3/T4 melanomas, p=0.02) 3
  • Higher rate of local and in-transit recurrences in elderly: 14.5% vs. 3.4% at 5 years (p<0.001) 3

Incidence Trends by Age Group

Between 1989 and 2015, age-standardized melanoma incidence in older men increased from 18 to 103 per 100,000 person-years, representing a nearly 6-fold increase 6

  • In older women: increased from 23 to 70 per 100,000 person-years 6
  • In younger men: increased from 8 to 21 per 100,000 person-years 6
  • In younger women: increased from 13 to 28 per 100,000 person-years 6

The gap in melanoma incidence between younger and older people is widening due to the disproportionate increase in elderly populations 6

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

4
Guideline

Melanoma Risk Factors and Prevention

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

7
Research

Melanoma in the older person.

Oncology (Williston Park, N.Y.), 2004

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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