Increases in invasive melanoma in England, 1979-2006, by anatomical site

Abstract

Background: National melanoma incidence trends with details of anatomical site have not been previously described for England.

Objectives: To describe site-specific trends in cutaneous melanoma for England as a whole during the last three decades.

Methods: Anonymized data, 1979-2006, were obtained from national cancer registrations of all patients in England up to age 89years with incident primary invasive cutaneous melanomas (n=124055). Sex-specific age-standardized incidence rates and average annual percentage change in rates were calculated for each broad anatomical site.

Results: Overall incidence rates of cutaneous melanoma in England, 1979-2006, were 81 and 100 per million, in males and females, respectively. Site-specific rates were consistently highest on the lower limbs in females followed by the trunk in males. Greatest annual increases occurred on the trunk in both sexes over 45years (males 9·9%, females 6·8%), then upper limbs (males 8·7%, females 6·8%). Incidence trends in males relative to females varied little across sites apart from a more rapid rise in head/neck melanomas in males than in females after the 1980s.

Conclusions: Invasive melanoma rates continue to rise in England, particularly on the trunk and arms, and in males on the head/neck. The steeper increases in melanoma rates among males are consistent with their greater sun exposure and poorer compliance with sun protection measures than females.

Fig 1

Incidence of cutaneous melanoma in males (per million person-years at risk) by anatomical site, in England, 1979–2006.

Fig 2

Incidence of cutaneous melanoma in females (per million person-years at risk) by anatomical site, in England, 1979–2006.

Fig 3

Cutaneous melanoma male to female (M : F) incidence rate ratios by anatomical site, in England, 1979–2006.