Melanoma Rates Among Non-Hispanic American Indian/Alaska Natives Vary by Age, Region

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A new study in JAMA Dermatology shed light on trends and incidence rates of invasive cutaneous melanoma in non-Hispanic American Indian/Alaska Native individuals. 

The cross-sectional observational study, focusing on a period from 1999 to 2019, included data drawn from a population-based cancer registry linked to the Indian Health Service (U.S. Cancer Statistics AI/AN Incidence Analytic Database). The researchers examined incidence rates over time by age, sex, region, histology, stage, and other demographic characteristics. Resident county characteristics (poverty level, rurality, education level, and socioeconomic status) were also included in the analysis. 

The analysis reported that 2,151 non-Hispanic American Indian/Alaska Native individuals (47.5% female) received a diagnosis of incident cutaneous melanoma (rate, 10.7 per 100,000; 95% CI, 10.3 to 11.2). Incidence rates were higher for males compared with female individuals (13.0 vs. 9.2 per 100,000) and for people 55 and older (24.2 vs. 22.8 per 100,000) when compared with individuals aged 15 to 39 years. The highest incidence rates occurred in males aged 55 years and older, and in people living in the Southern Plains and Pacific Coast regions. The researchers also reported an increase in incidence in females from 1999 to 2019 (annual percent change, 2.5; P<0.001), and increase among regional/distant stage tumors (annual percent change, 2.5; P=0.01) and in people aged 55 and older (annual percent change, 2.8; P=0.001).

"The results of this study suggest that additional studies could potentially identify risk factors among non-Hispanic American Indian/Alaska Native people," the researchers wrote

In an accompanying editorial by Lucinda Kohn, MD, Shannon Zullo, MD, and Spero Manson, PhD, the authors noted that the methods used in the present analysis corrected for racial misclassification among American Indian/Alaska Native patients with melanoma.

"These findings suggest that previous studies may have overlooked American Indian/Alaska Native health disparities and underscore the importance of minimizing racial misclassification in this population," they wrote.

Key Takeaways

  •  Non-Hispanic American Indian/Alaska Native people have the second highest incidence rate of invasive cutaneous melanoma in the U.S. after non-Hispanic White people.
  • In this analysis, invasive cutaneous melanoma incidence rates were higher among men, individuals aged 55 years and older, and those living in the Southern Plains and Pacific Coast regions. 
  • Incidence rates increased for women between 1999 and 2019.
  • Individuals aged 40 years and older saw increases in incidence rates between 1999 and 2019.
  • Incidence rates increased for individuals with a diagnosis of regional/distant tumor between 1999 and 2019.


Townsend JS, Melkonian SC, Jim MA, et al. Melanoma incidence rates among non-Hispanic American Indian/Alaska Native Individuals, 1999-2019. JAMA Dermatology. Published online December 27, 2023. 

Kohn LL, Zullo SW, Manson SM. High melanoma rates in the American Indian and Alaska Native Population—a unique challenge. JAMA Dermatology. Published online December 27, 2023.


The authors report no conflicts or disclosures. 

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