The Surgeon, Genetics, and Malignant Melanoma

We are now facing an epidemic of cutaneous malignant melanoma (CMM), with projections that one in 100 whites will develop CMM by the year 2000. Physicians must employ their accrued knowledge of the epidemiologic and genetic aspects of CMM to maximize control. Excessive, intermittent exposure to sunlight during outdoor recreational activities has been implicated in the origin of CMM in whites. In addition, the recently demonstrated depletion of the ozone layer in the stratosphere of the northern hemisphere can significantly affect the incidence of skin cancer. It has been shown in Australia that exposure to sunlight in the first two decades of life significantly increases the risks of developing CMM.¹ To be cost-effective in the face of rising health care costs, we must be able to efficiently identify high-risk patients and families so that highly targeted surveillance, early diagnosis, and treatment can be accomplished. It will also be necessary,