Melanoma epidemic: an analysis of six decades of data from the Connecticut Tumor Registry

Abstract

Purpose: Melanoma is the most commonly fatal form of skin cancer, with nearly 50,000 annual deaths worldwide. We sought to assess long-term trends in the incidence and mortality of melanoma in a state with complete and consistent registration.

Methods: We used data from the Connecticut Tumor Registry, the original National Cancer Institute SEER site, to determine trends in invasive melanoma (1950-2007), in situ melanoma (1973-2007), tumor thickness (1993-2007), mortality (1950-2007), and mortality to incidence (1950-2007) among the 19,973 and 3,635 Connecticut residents diagnosed with invasive melanoma (1950-2007) and who died as a result of melanoma (1950-2007), respectively. Main outcome measures included trends in incidence and mortality by age, sex, and birth cohort.

Results: In the initial period (1950-1954), a diagnosis of invasive melanoma was rare, with 1.9 patient cases per 100,000 for men and 2.6 patient cases per 100,000 for women. Between 1950 and 2007, overall incidence rates rose more than 17-fold in men (1.9 to 33.5 per 100,000) and more than nine-fold in women (2.6 to 25.3 per 100,000). During these six decades, mortality rates more than tripled in men (1.6 to 4.9 per 100,000) and doubled in women (1.3 to 2.6 per 100,000). Mortality rates were generally stable or decreasing in men and women through age 54 years.

Conclusion: Unremitting increases in incidence and mortality of melanoma call for a nationally coordinated effort to encourage and promote innovative prevention and early-detection efforts.

Fig 1.

Invasive melanoma rates in Connecticut Tumor Registry from 1950 to 2007 by sex, age, and time period (estimates from Poisson regression model). Time periods centered on mid-decade year; note that first two time periods actually straddle second year of decade.

Fig 2.

Invasive melanoma rates in Connecticut Tumor Registry from 1890 to 1970 by sex, age, and birth cohort (estimates from Poisson regression model). Time periods centered on mid-decade year, with birth cohorts centered on decade.

Fig 3.

Melanoma rates in Connecticut Tumor Registry from 1950 to 2007 by sex, age, and time period (estimates from Poisson regression model). Time periods centered on mid-decade year, with birth cohorts centered on decade.

Fig 4.

Melanoma rates in Connecticut Tumor Registry from 1890 to 1970 by sex, age, and birth cohort (estimates from Poisson regression model). Time periods centered on mid-decade year, with birth cohorts centered on decade.