Review
Incidence, mortality and survival in cutaneous melanoma

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Summary

Cutaneous melanoma remains a challenge despite increased levels of awareness, education and targeted health policies. Worldwide incidence rates for cutaneous melanoma have risen faster than those for any other malignancy in Caucasian populations over the last 30 years.

Despite improving survival rates (defined as the ratio of those who survive the disease against incidence) over this period, mortality rates, generally, have continued to climb. Mortality from melanoma is greater than that caused by all other types of skin cancer, especially in men. In Britain the percentage of increase in the male age standardised mortality rate surpassed that of all other malignancies assessed (1993–2002) by Cancer Research UK.

A literature-based study was conducted with review of publications identified through Medline and EMBase, 1980–December 2005, databases.

We present a review of the current literature on incidence, mortality and survival rates of melanoma including a discussion on the aetiological factors, behaviour modification associated with public education campaigns and recent health policies and the effect these are having on melanoma figures.

It is likely that any fall in mortality rates from melanoma in the near future will be secondary to early detection. Changes resulting from primary prevention are unlikely to be noticeable for several decades.

Section snippets

Materials and methods

Recent literature was reviewed to establish current cutaneous melanoma incidence, mortality and survival trends together with the latest information on aetiology and behaviour.

Medline and EMBase databases from 1980 to December 2005 were searched by using the ‘Explode’ command in Ovid to retrieve articles for a series of Medical Subject Headings (MeSH) including cutaneous melanoma incidence or mortality or survival and sunlight, ultraviolet radiation, ozone, behaviour, and tan. Textword

Incidence

Worldwide incidence rates for CM vary up to 150-fold20 with World Health Organisation estimates of 132 000 new cases of CM per year internationally.20 In the UK, incidence rates have more than doubled over the last 20 years21 and in the last 5 years alone, CM incidence has increased by 28% in men and 12% in women.22 Similar increases have been seen across all populations (particularly Caucasian populations as these are approximately 20 times more likely to develop CM than darker skinned groups23

Discussion

Worldwide, the incidence of CM continues to rise overall although generally at a slower rate than that seen in the past. The exceptions to this trend are that the older male populations in whom increases in melanoma incidence, particularly in thick worse prognosis tumours, continue unabated. It appears that a significant proportion of the continued increment in CM incidence among younger age groups is in thinner better prognosis tumours. Although some of this may be due to earlier diagnosis,

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