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Diagnosis and Treatment of Early Melanoma NIH Consensus Development Panel on Early Melanoma

Lowell A. Goldsmith, MD; Frederic B. Askin, MD; Alfred E. Chang, MD; Cynthia Cohen, MB, BCh; Janice P. Dutcher, MD; Robert S. Gilgor, MD; Stephanie Green, PhD; Emily L. Harris, PhD, MPH; Stephen Havas, MD, MPH, MS; June K. Robinson, MD; Neil A. Swanson, MD; Margaret A. Tempero, MD; A. Bernard Ackerman, MD; Charles M. Balch, MD; Natale Cascinelli, MD; Wallace H. Clark, MD; Evan R. Farmer, MD; DuPont Guerry IV, MD; Alan N. Houghton, MD; Howard K. Koh, MD; Alfred W. Kopf, MD; Kenneth H. Kraemer, MD; Rona M. MacKie, MD, FRCP, FRCPath, FRSE; John C. Maize, MD; Frank L. Meyskens Jr, MD; Douglas A. Perednia, MD; Michael W. Piepkorn, MD, PhD; Darrell S. Rigel, MD, MS; Gary S. Rogers, MD; Richard W. Sagebiel, MD; Arthur J. Sober, MD; Margaret A. Tucker, MD; Mary R. Wick, MD; John J. Zone, MD; Alan N. Moshell, MD; Elaine Blume; Elsa Bray; Jerry M. Elliott; John H. Ferguson, MD; Mary B. Gregg, MS, MBA; William H. Hall; Donald E. Henson, MD; Stephen I. Katz, MD, PhD; Michael T. Lotze, MD; John Maize, MD; Kavon H. Safavi, MD, MPH; Arthur Sober, MD
JAMA. 1992;268(10):1314-1319. doi:10.1001/jama.1992.03490100112037.
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THE INCIDENCE of melanoma of the skin appears to be rapidly rising. The increased incidence may be partially attributable to increased detection resulting from screening. In 1992, approximately 32000 newly diagnosed cases and 6700 deaths are expected in the United States. Melanoma tends to occur in adults in the prime of their family and professional lives. Detection and surgical treatment of the early stages of this malignancy are usually curative. In contrast, diagnosis and treatment in late stages often have dismal results.

Traits associated with an increased risk of developing melanoma include multiple typical moles, atypical moles, freckling, history of severe sunburn, ease of burning, inability to tan, and light hair with blue eyes. Other factors include the presence of familial atypical mole and melanoma syndrome, disorders of DNA repair, and excessive sun exposure.

Efforts to increase public awareness of melanoma and its treatment without causing unnecessary fear present a


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