Recent developments in melanoma epidemiology, 1993.

Recent work on melanoma epidemiology up to and including the Third International Conference in 1993 shows that in several countries mortality trends have stabilized or are decreasing, although incidence continues to increase. Despite specific attention, evidence for a role of factors other than sun and ultraviolet exposure is weak. The established aetiological factors are sun exposure, particularly intermittent exposure, and exposure to artificial sources of ultraviolet radiation. Acquired naevi are also related to sun exposure and may be a useful biological marker, as may be mutations such as p53. Evidence for the effectiveness of educational efforts to reduce sun exposure of populations is now provided by Australian work, and studies in Scotland demonstrate the effectiveness of public education in early diagnosis. A major unresolved issue is the value or otherwise of population screening, and systematic trails are required.