Changing trends in the incidence of invasive melanoma in Victoria, 1985–2015

Curchin, David J; Harris, Victoria; McCormack, Christopher; Smith, Saxon D

doi:10.5694/mja17.00725

Cited by 28 publications

(18 citation statements)

References 25 publications

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“…There may have been selection bias as the VMS is a statewide tertiary referral service to which patients with advanced or aggressive disease are more likely to have been referred. Nevertheless, overall findings on melanoma distribution were consistent with statewide cancer registry data, despite invasive melanoma being overrepresented (76.6% in our cohort vs 56.1% Victorian Cancer Registry) . Furthermore, like other population studies, we found consistency in melanoma incidence rates between contiguous sites with similar sun exposure (e.g.…”

Section: Discussionsupporting

confidence: 91%

The anatomic distribution of cutaneous melanoma: A detailed study of 5141 lesions

et al. 2019

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Background/Objectives: There is evidence that cutaneous melanomas at different anatomic sites present with distinctive clinicopathologic features. We examined the anatomic distribution of cutaneous melanoma and its variation by patient characteristics, subtype and Breslow thickness, using high-resolution anatomic site data. Methods:A cross-sectional study was performed of all primary cutaneous melanoma cases managed at a tertiary referral centre, analysing prospectively collected clinical data across 50 anatomic subsites. Results:The study included 5141 in situ or invasive melanomas; most were invasive (76.2%), and the median Breslow thickness of invasive lesions was 1.0 mm. Superficial spreading (57.2%), lentigo maligna (20.8%) and nodular (12.2%) were the most common histopathological subtypes. Sun-exposed sites such as the female nose and cheek, the male ear, as well as the upper back in both sexes had the highest incidence of melanoma per unit area. When compared to the posterior forearm, the scalp, ear, preauricular, perioral, subungual and plantar sites had thicker invasive melanomas (each P < 0.05). The peri-auricular, ear and cheek had the highest incidence of nodular melanoma per unit area. There were subtype-, age-and sex-specific differences in melanoma anatomic distribution.Conclusion: Melanoma most commonly arises in sun-exposed facial areas, as well as the upper back. Increased thickness is found for melanoma in acral and many head and neck sites. Nodular melanoma is more likely to occur in head and neck sites including the peri-auricular area, ear and cheek. Clinicians should carefully assess these sites during skin examinations.

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Section: Discussionsupporting

confidence: 91%

The anatomic distribution of cutaneous melanoma: A detailed study of 5141 lesions

et al. 2019

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“…1 Although there is a lower incidence of MCC than melanoma (46.0 per 100 000 population age-standardised in Victoria 2015), there are similar trends in increase in the older population with higher rates among men. 16 As with other skin cancers the link between UV radiation in the development of MCC is well noted. 2 The rates on MCC were correlated with melanoma regardless of geographical latitude.…”

Section: Discussionmentioning

confidence: 99%

Trends in the incidence of Merkel cell carcinoma in Victoria, Australia, between 1986 and 2016

et al. 2019

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Background/Objectives Merkel cell carcinoma (MCC) is a highly invasive cutaneous malignancy. The objective of this study was to investigate the incidence and trends of MCC in Victoria, Australia, between 1986 and 2016. Methods Population‐based, descriptive analysis of Victorian Cancer Registry (VCR) data. The de‐identified records of patients with MCC were obtained from Victoria residents diagnosed between 1986 and 2016. Trends in age‐standardised incidences were examined using joinpoint analysis. Results A total of 1095 cases were found. Incidence of MCC was 3.9 per 100 000 for men and 1.5 per 100 000 for women. The incidence of MCC in men 66–85 is increasing at an annual rate of 4.2% (2.8–5.8%, 95% CI). However, since 2002 the incidence in women in the same age group has been decreasing. Whilst there is an overall stabilisation in the incidence of MCC, incidence of MCC for males is increasing. For MCC in males 85 years old and over, the incidence of MCC was 26.8 per 100 000 between 2012 and 2016. Relative 5‐year survival for patients diagnosed between 2008 and 2012 is 50%. Conclusion Merkel cell carcinoma remains an aggressive cancer, especially among older men. Differences in trends seen in local data can help target preventative and early intervention management strategies in specific groups.

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“…The incidence of invasive melanoma in Australia continues to rise in older age groups, but it has plateaued and decreased in younger age groups over recent years 6,7 . In contrast, over a 20‐year period, incidence of in situ melanoma has increased in all age groups 3 .…”

Section: Current Australian Screening Policy and Practicementioning

confidence: 99%

“…5 The incidence of invasive melanoma in Australia continues to rise in older age groups, but it has plateaued and decreased in younger age groups over recent years. 6,7 In contrast, over a 20-year period, incidence of in situ melanoma has increased in all age groups. 3 Based on Medicare data, skin biopsy rates have also increased by 66% over the past decade 8 and the economic burden is increasing steadily.…”

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confidence: 99%

Early detection of melanoma: a consensus report from the Australian Skin and Skin Cancer Research Centre Melanoma Screening Summit

Janda

Cust

Aitken

et al. 2020

Australian and New Zealand Journal of Public Health

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Introduction: A Melanoma Screening Summit was held in Brisbane, Australia, to review evidence regarding current approaches for early detection of melanomas and explore new opportunities. Results: Formal population‐based melanoma screening is not carried out in Australia, but there is evidence of considerable opportunistic screening as well as early detection. Biopsy rates are rising and most melanomas are now diagnosed when in situ. Based on evidence review and expert opinion, the Summit attendees concluded that there is currently insufficient information in terms of comparative benefits, harms and costs to support change from opportunistic to systematic screening. Assessment of gains in precision and cost‐effectiveness of integrating total body imaging, artificial intelligence algorithms and genetic risk information is required, as well as better understanding of clinical and molecular features of thin fatal melanomas. Conclusions: Research is needed to understand how to further optimise early detection of melanoma in Australia. Integrating risk‐based population stratification and more precise diagnostic tests is likely to improve the balance of benefits and harms of opportunistic screening, pending assessment of cost‐effectiveness. Implications for public health: The Summit Group identified that the personal and financial costs to the community of detecting and treating melanoma are rising, and this may be mitigated by developing and implementing a more systematic process for diagnosing melanoma.

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Changing trends in the incidence of invasive melanoma in Victoria, 1985–2015

Abstract: Melanoma remains a significant health problem, warranting continued prevention efforts. Awareness of differences in presentation by men and women and in different age groups would facilitate improved screening and risk identification.

Cited by 28 publications

References 25 publications

The anatomic distribution of cutaneous melanoma: A detailed study of 5141 lesions

The anatomic distribution of cutaneous melanoma: A detailed study of 5141 lesions

Trends in the incidence of Merkel cell carcinoma in Victoria, Australia, between 1986 and 2016

Early detection of melanoma: a consensus report from the Australian Skin and Skin Cancer Research Centre Melanoma Screening Summit

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