While surveys in several developed countries have provided accurate data on the incidence of cutaneous melanoma (CM), the resulting mortality, and the changes in these parameters over time, information from South Africa is sparse in comparison. Reasons for the differences in CM between the two population groups are suggested. The stage of CM at diagnosis tends to be more advanced in Black Africans than in Whites and, similarly, the survival rates are considerably lower in Black Africans. Risk factors including exposure to the sun, trauma, human immunodeficiency virus infection, albinism, age, and genetics are summarized and are likely to differ between the two population groups. Most CMs in both male and female Black Africans are found on the lower leg and/or hip with a significant proportion being acral lentiginous melanoma, a subtype rarely seen in Whites. The commonest CM subtype in Whites is superficial spreading it occurs on various body sites, the most frequent being the trunk in males and the lower leg/hip in women. The incidence has probably risen in Whites over the past 40 years but seems to be unchanged in Black Africans. The incidence of CM in Black Africans is about 10% of that in Whites, explained at least in part by the protection offered by cutaneous melanin. In this chapter, two South African population groups, White and Black African, are compared with regard to cutaneous melanoma (CM).
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