Melanoma rates are decreasing and much of the decrease among men is among women or increases in men, according to data from a recent study.

But the study, published Nov. 7, 2018 in JAMA Oncology, does not indicate that men are suffering from the same degree of mortality caused by melanoma that women are, especially among younger people who were most likely to undergo treatment for the disease at the start of study.

Older adults, people 65 and older, who had undergone yearly oral cancer surgery were the most likely to die of melanoma, while the least than 10 percent of those who received radiation therapy alone for the disease died.

“Our results do not represent an endorsement for immediate and aggressive treatment of all patients because women are disproportionately affected by the disease,” said the study’s lead author, David E. Peterson, PhD, dean and associate vice-chair of the Henry M. Jackson Foundation-backed Cancer Center at the University of Illinois at Chicago.

“Although we do not have direction here, we can say that it is likely women are worse off than men,” Dr. Peterson said in a university news release.

The report offers little data since many melanoma deaths are highly underreported and the researchers acknowledged the potential limitations of the study, including a lack of information on specific treatments received, or maintenance therapy, or monitoring of a cancer patient’s disease progression. Study participants interrogated by the researchers were mostly white and high-risk — those with less than a 10 percent chance of developing melanoma and no site-based screening for the disease.

Death registration data they provided included six deaths: five among people in the permanent group, one from a non-participant, one in the permanent group and one from a non-participant who was treated with isotonic radiation therapy. A fourth death was from metastatic melanoma, caused by tumors elsewhere in the body.

Because the data reflected how often patients sought treatment, the researchers were not able to estimate the absolute number of melanoma deaths among the group. Based upon the results, approximately 10.8 percent of the people in the study were dying from melanoma, Dr. Peterson said.

Not every type of cancer seems to be dying at the same rates as before. The study found no statistically significant drops in the number of deaths among those with breast cancer, melanoma and colorectal cancer, prostate cancer and kidney cancer.

Although the study did find an overall fertility rate in men aged 35-44, the exact rate in each age group was not statistically significant.

Because the results are based on self-reported data, measuring women’s fertility may not adequately capture some women who might be missing a significant amount of melanoma deaths.

About 5,400 people will be diagnosed with melanoma in the United States this year, Dr. Peterson said. The vast majority, about 81 percent, of melanoma deaths occurred in women. Men over 50 years of age accounted for about 88 percent of the deaths.

As of 2018, there were nearly 250,000 cases of melanoma (more than 80,000 in women younger than 35 and more than 70,000 in men over this age), and 34,590 deaths among women and nearly 40,300 deaths among men, Dr. Peterson and his colleagues said.

While fewer than half of melanoma deaths among women occurred in men, the findings showed statistically significant increases among men, the study found.

Most deaths involved people who were in the permanent group (99 percent). A similar number of deaths occurred in the first stage of at least one type of cancer — colon cancer.

The study did not provide information on whether there were drugs, surgery, radiation therapy or other treatments for cancer among patients who died of melanoma.

It will take more than a decade, however, for melanoma to be diagnosed and treated in the same way women are so routinely treated, Dr. Peterson said.

“We need to find out, among other things, whether some of the changes in the way melanoma is diagnosed and treated in our program are not of men and whether they are less common among men than women,” he said.

While more research is needed, the results offer fresh evidence that the need for screening and surveillance far outweighs the need for screening guidelines and overtreatment practices in women, said Dr. Richard Goldner, MD, president of the Medical Advisory Council’s Melanoma is Getting Better Initiative, which created the images for the articles.

“More must be done to highlight the many risk factors for the disease among men and women,” Dr. Goldner said in an interview from Los Angeles. “Further, it is important to