Precursors of malignant melanoma. Problems in computing the risk of malignant melanoma arising in dysplastic and congenital nevocytic nevi

The mortality rate of malignant melanoma is increasing faster than any other cancer in the United States escept for cancer of the lung. Similarly, the incidence of malignant melanoma has been rising consistently in the past few decades. Using current data, one American in 185 will develop cutaneous malignant melanoma. With preliminary evidence indicating that some malignant melanomas may arise from precursor lesions such as dysplastic nevi and congenital nevocytic nevi, it is important to identify the true contribution of these lesions to the increased incidence and mortality rate of malignant melanoma. With the accurate assessment of this risk, appropriate strategies for the management of these precursor lesions can be formulated. The accurate computation of the true risk of these lesions evolving into malignant melanoma cannot be currently accomplished. Therefore, recommendations for the prophylactic removal of all dysplastic nevi and all congenital nevi are premature.