OCCURRENCE OF MELANOMAS ON THE UPPER AND SOWER LIMBS IN EASTERN AUSTRALIA

In view of the changing trends in the incidence of melanoma at differe nt body sites and in particular on the limbs, the detailed distributio ns of over 10,000 invasive melanomas diagnosed on the upper and lower limbs in residents of mainland eastern Australia between 1987 and 1993 were examined. Cancer notifications and histopathology reports from t he cancer registries of Queensland, New South Wales and Victoria were searched manually, and subsites when specified were recorded as should er, upper arm, forearm, elbow, wrist or hand, and thigh, leg, knee, an kle or foot, On the upper limbs relative tumour densities were highest on the shoulder, approximately equal on the upper arm and forearm and least on the hand in both men and women; on the lower limbs melanomas occurred more than twice as often on the leg than on the thigh or the foot, taking account of surface area. There was a clear inverse gradi ent of incidence of melanoma with latitude in the three eastern Austra lian states studied, but little difference between the states or betwe en sexes in distribution of histological type: the majority specified being specified as superficial spreading melanomas, In contrast to pre dictions based on apparent frequency of sun exposure at subsites on th e upper limbs, the relative concentration of melanomas on the shoulder suggests that wearing sleeveless garments outdoors in the sun should be avoided whenever possible. Also, the similar densities of leg and f orearm melanomas seems inconsistent with the relative degree of exposu re of each and further suggests that women's adoption of ankle-length skirts or trousers, in preference to knee-length skirts would be a wor thwhile modern control measure.