Superficial Spreading Melanoma

In the Americas, the earliest cases of melanoma date to pre Columbian times. Deposits of melanin pigment indicative of metastases have been found in the bones of Inca mummies. However, the disease was and is rare among the native peoples of the americas. It was not until the early part of the 20th century that the constellation of events began to converge that later resulted in a rapid rise of incidence of cutaneous melanoma. The first was the immigration of large numbers of sun sensitive Europeans, such as those of Celtic ancestry, to the Americas, particularly to the United States and Canada. The estalishment of hair labor practices led to the end of the "sun up to sun down" workday and the advent of leisure time. Clothing for both men and women became less complicated and skimpier. The ideal of a 'peaches and cream" complexion was replaced by the search for the perfect suntan. Ladies with parasols and men with hats gave way to teenagers with Speedos and bikinis. Who among the baby boomers does not remember baby oil and iodine? The net result is that the lifetime risk of developing melanoma for a Caucasian individual born and raised in the United States has now risen to about 1 in 90.

Public Health officials were slow to recognize the deleterious effects of the sun. And as with other health preserving lifestyle recommendations (such as smoking cessation), the public has been slow to adopt sun sense advice. However, the media have done an excellent job in educating the public to the dangers of the sun's ultraviolet rays and increasing public awareness of the early signs of cutaneous melanoma and other skin cancers.