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Trends for in situ and Invasive Melanoma in Queensland, Australia, 1982–2002

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Abstract

Objectives Queensland, the north-eastern state of Australia, has the highest incidence of melanoma in the world. Control measures started earlier here than probably anywhere else in the world; early detection programmes started in the 1960s and primary prevention in the 1980s. Data from the population-based Queensland Cancer Registry therefore provide an internationally unique data source with which to assess trends for in situ and invasive melanomas and to consider the implications for early detection and primary prevention.

Methods We used Poisson regression to estimate the annual percentage change in rates across 21 years of incidence data for in situ and invasive lesions, stratified by age and sex. Joinpoint analyses were used to assess whether there had been a statistically significant change in the trends.

Results In situ melanomas increased by 10.4% (95% CI: 10.1%, 11.1%) per year among males and 8.4% (7.9%, 8.9%) per year among females. The incidence of invasive lesions also increased, but not as quickly; males 2.6% (2.4%, 2.8%), females 1.2% (0.9%, 1.5%). Valid data on thickness was only available for 1991 to 2002 and for this period thin-invasive lesions were increasing faster than thick-invasive lesions (for example, among males: thin 3.8%, thick 2.0%). We found some suggestive evidence of lower proportionate increase for the most recent years for both in-situ and invasive lesions, but this did not achieve statistical significance. Among people younger than 35 years, the incidence of invasive melanoma was stable and there was a suggestion of a birth cohort effect from about 1958. Mortality rates were stable across all ages, and there was a suggestion of decreasing rates among young women, although this did not achieve statistical significance.

Conclusion Age-standardised incidence is continuing to increase and this, in combination with a shift to proportionately more in situ lesions, suggests that the stabilisation of mortality rates is due, in large part, to earlier detection. For primary prevention, after a substantial period of sustained effort in Queensland, there is some suggestive, but not definitive, evidence that progress is being made. Incidence rates are stabilising in those younger than 35 years and the proportionate increase for both in situ and invasive lesions appears to be lower for the most recent period compared with previous periods. However, even taking the most favourable view of these trends, primary prevention is unlikely to lead to decreases in the overall incidence rate of melanoma for at least another 20 years. Consequently, the challenge for primary prevention programmes will be to maintain momentum over the long term. If this can be achieved, the eventual public-health benefits are likely to be substantial.

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References

  1. Australian Institute of Health & Welfare. Cancer in Australia, 2001. AIHW Cat No CAN18. Canberra, AIHW 2004

  2. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB (2003) Cancer Incidence in Five Continents. Vol. VIII, Lyon, IARC, IARC Publication No 155

  3. NC Davis JJ Herron (1966) ArticleTitleQueensland Melanoma Project: organisation and a plea for comparable surveys Med J Aust 1 643–644 Occurrence Handle1:STN:280:CCmC38vntlY%3D Occurrence Handle5930910

    CAS  PubMed  Google Scholar 

  4. T Smith (1979) ArticleTitleThe Queensland Melanoma Project – an exercise in health education BMJ i 253–254

    Google Scholar 

  5. J Esteve E Benhamou L Raymond (1994) Statistical Methods in Cancer Research, Descriptive Epidemiology IARC Lyon

    Google Scholar 

  6. M Thorn F Ponten A Johansson R Bergstrom (1998) ArticleTitleRapid increase in diagnosis of cutaneous melanoma in situ in Sweden, 1968–1992 Cancer Detect Prevent 22 430–437 Occurrence Handle1:STN:280:DyaK1czpsVKjtQ%3D%3D Occurrence Handle9727624

    CAS  PubMed  Google Scholar 

  7. DJ Ruiter Particlevan CR Dijk CM Ferrier (2003) ArticleTitleCurrent diagnostic problems in melanoma pathology Sem Cut Med Surg 22 33–41

    Google Scholar 

  8. R Mahendran JA Newton-Bishop (2001) ArticleTitleSurvey of UK current practice in the treatment of lentigo maligna Br J Dermatol 144 71–76 Occurrence Handle1:STN:280:DC%2BD3M3gsVWntQ%3D%3D Occurrence Handle11167685 Occurrence Handle10.1046/j.1365-2133.2001.03954.x

    Article  CAS  PubMed  Google Scholar 

  9. LD Marrett HL Nguyen BK Armstrong (2001) ArticleTitleTrends in the incidence of cutaneous malignant melanoma in New South Wales, 1983–1996 Int J Cancer 92 457–462 Occurrence Handle1:STN:280:DC%2BD3M3hvVSisA%3D%3D Occurrence Handle11291086 Occurrence Handle10.1002/ijc.1203

    Article  CAS  PubMed  Google Scholar 

  10. DM Roder CG Luke KA McCaul AJ Esterman (1995) ArticleTitleTrends in prognostic factors of melanoma in South Australia, 1981–1992: implication for health promotion Med J Aust 162 25–29 Occurrence Handle1:STN:280:ByqC2cjnslE%3D Occurrence Handle7845294

    CAS  PubMed  Google Scholar 

  11. H Kim MP Fay EJ Feuer DN Midthune (2000) ArticleTitlePermutation tests for joinpoint regression with applications to cancer rates Stat Med 19 335–351 Occurrence Handle1:STN:280:DC%2BD3c7hsF2gug%3D%3D Occurrence Handle10649300 Occurrence Handle10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z

    Article  CAS  PubMed  Google Scholar 

  12. JA Lee (2001) ArticleTitleThe systematic relationship between melanomas diagnosed in situ and when invasive Mel Res 11 523–529 Occurrence Handle1:STN:280:DC%2BD3MrkvFantg%3D%3D

    CAS  Google Scholar 

  13. MH Schiffman LA Brinton SS Devesa J Fraumeni F Joseph (1996) Cervical cancer D Schottenfeld J Fraumeni F Joseph (Eds) Cancer Epidemiology and Prevention Oxford University Press New York

    Google Scholar 

  14. JS Mandel TR Church JH Bond F Ederer et al. (2002) ArticleTitleThe effect of fecal occult-blood screening on the incidence of colorectal cancer NEJM 343 1603–1607

    Google Scholar 

  15. RC Burton BK Armstrong (1998) ArticleTitleNon-metastasizing melanoma? J Surg Oncol 67 73–76 Occurrence Handle1:STN:280:DyaK1c7ks1Wrsw%3D%3D Occurrence Handle9486776 Occurrence Handle10.1002/(SICI)1096-9098(199802)67:2<73::AID-JSO1>3.0.CO;2-I

    Article  CAS  PubMed  Google Scholar 

  16. JL Rees (1996) ArticleTitleThe melanoma epidemic: reality or artefact? Warrants a reappraisal of the relation between histology and clinical behaviour BMJ 312 137–138 Occurrence Handle1:STN:280:BymC2M3gtFA%3D Occurrence Handle8563526

    CAS  PubMed  Google Scholar 

  17. BK Armstrong A Kricker (1994) ArticleTitleCutaneous melanoma Cancer Surv 19 219–240 Occurrence Handle7534627

    PubMed  Google Scholar 

  18. LA Gaudette RN Gao (1998) ArticleTitleChanging trends in melanoma incidence and mortality Health Rep 10 29–41 Occurrence Handle1:STN:280:DyaK1M%2FlvVKhuw%3D%3D Occurrence Handle9842489

    CAS  PubMed  Google Scholar 

  19. HI Hall DR Miller JD Rogers B Bewerse (1999) ArticleTitleUpdate on the incidence and mortality from melanoma in the United States J Am Acad Dermatol 40 35–42 Occurrence Handle1:STN:280:DyaK1M7hvV2rsQ%3D%3D Occurrence Handle9922010 Occurrence Handle10.1016/S0190-9622(99)70562-1

    Article  CAS  PubMed  Google Scholar 

  20. TR Holford (1991) ArticleTitleUnderstanding the effects of age, period and cohort on incidence and mortality rates Ann Rev Public Health 12 425–457 Occurrence Handle1:STN:280:By6B28vptF0%3D Occurrence Handle10.1146/annurev.pu.12.050191.002233

    Article  CAS  Google Scholar 

  21. SH Moolgavkar JA Lee RG Stevens (1998) Analysis of vital statistics data KJ Rothman S Greenland (Eds) Modern Epidemiology Lippincott-Raven Publishers, Philadelphia 481–498

    Google Scholar 

  22. A Jemel SS Devesa P Hartge MA Tucker (2001) ArticleTitleRecent trends in cutaneous melanoma incidence among whites in the United States J Natl Cancer Inst 93 678–683

    Google Scholar 

  23. DC Whiteman CA Whiteman AC Green (2001) ArticleTitleChildhood sun exposure as a risk factor for melanoma: a systematic review of epidemiologic studies Cancer Causes Control 12 69–82 Occurrence Handle1:STN:280:DC%2BD3M3ksVyktw%3D%3D Occurrence Handle11227927 Occurrence Handle10.1023/A:1008980919928

    Article  CAS  PubMed  Google Scholar 

  24. AJ Chamberlain JW Kelly (2004) ArticleTitleNodular melanomas and older men: a major challenge for community surveillance programs Med J Aust 180 432 Occurrence Handle15089743

    PubMed  Google Scholar 

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Acknowledgements

We thank Professor Robert MacLennan for helpful discussions and advice.

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Correspondence to Michael Coory.

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Coory, M., Baade, P., Aitken, J. et al. Trends for in situ and Invasive Melanoma in Queensland, Australia, 1982–2002. Cancer Causes Control 17, 21–27 (2006). https://doi.org/10.1007/s10552-005-3637-4

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