P198 Identifying risk factors for melanoma in patients aged < 50 years: a retrospective observational study from a UK district dermatology service

Abstract

Melanoma incidence is increasing in younger adults, yet UK-based research describing risk factor patterns in this population remains limited. Known risk factors include family history, high naevus burden and ultraviolet exposure. Understanding the distribution of behavioural and clinical risk factors may inform prevention, counselling and risk-stratified follow-up. The aim of this study was to describe the prevalence of behavioural and clinical risk factors in patients diagnosed with melanoma under age 50 years. A retrospective observational study involved review of clinic letters and patient records of individuals aged 20–49 years diagnosed with a primary malignant melanoma over a 2-year period (April 2023 to May 2025) in a UK district general hospital dermatology service. Extracted variables included indoor tanning, history of severe sunburns, outdoor occupation, residence abroad in high-­ultraviolet settings, family history of melanoma, immunocompromise, high naevus count (> 50) and Fitzpatrick skin type. Data were summarized descriptively. Sixty-eight patients were identified. The majority had lighter skin (Fitzpatrick I–II, 94%). Overall, 93% had at least one identifiable behavioural or familial risk factor, and 65% had two or more. The most frequent features were history of severe sunburn (56%), family history of melanoma (44%), indoor tanning (41%; disproportionately affecting women: 56% compared with 19% of men), high naevus count (34%), residence abroad in high-ultraviolet settings (25%) and outdoor occupation (19%). In this UK cohort, melanoma diagnosed in patients aged < 50 years was rarely devoid of identifiable risk factors. Beyond light skin types, the high prevalence of behavioural and familial risk factors highlights opportunities for structured risk documentation, targeted counselling and prevention, particularly addressing indoor tanning and sun safety. The presence of these recognized risk factors in younger adults should heighten clinical suspicion and prompt careful assessment for melanoma. We call for further UK-based research to inform the development of risk-stratified surveillance pathways in young patients with multiple risk factors for melanoma.