Time trends in the incidence of malignant melanoma of the anatomic subsites of the upper limb in Connecticut from 1935 to 1984 were examined. Among males, the incidence of melanoma of the hand was stable, in sharp contrast to the 15-fold to 16-fold increase in the upper arm and forearm. Among females, the %fold increase in melanoma of the hand was substantially less than the 12-fold to 14-fold increase in the upper arm and forearm. However, melanoma of the dorsal surface of the hand in females increased sevenfold. These results are in partial agreement with the hypothesis that the hand would be relatively resistant to increased melanoma incidence because it has continually been a sun-exposed site over the decades. The results contradict the hypothesis that the rise in incidence would be greater in the upper arm (a usually unexposed site that has received increasing exposure due to changes in recreation and dress habits) than in the forearm (a site of intermediate exposure). Cancer 68:1854-1858,1991. HE RAPID RISE in the incidence of malignant mela-T noma over the last several decades among white populations tbroughout the world has been well documented.' This rise has generally been attributed to increased exposure to ultraviolet light from the sun due to changes in clothing fashions and leisure time habits.
In Connecticut, Norway, Denmark, Sweden, and Finland, where long-term, population-based malignant melanoma incidence data are available from tumor registries, time trends in malignant melanoma incidence have been analyzed by anatomic site.2-6 Consistently, the smallest increases in incidence rates have been observed for the face (sometimes grouped with the scalp and/or neck) compared with the trunk, lower limb, and upper limb.