Melanoma incidence trends and survival in adolescents and young adults in Queensland, Australia

Abstract

Cutaneous melanoma is a relatively common cancer in adolescents and young adults in Australia, but detailed information about occurrence patterns and prognosis is limited. We evaluated incidence trends from 1982 to 2010 and recent survival rates in those aged 15–24 years in the state of Queensland. In situ and invasive melanoma cases were identified from the Queensland Cancer Registry. Incidence rates were age-standardised to the 2000 World population and trends calculated using joinpoint regression. Five-year relative survival was estimated by the period method and Poisson models were used to produce adjusted mortality hazard ratios. Average annual incidence rates for the 5-year period 2006–2010 were 6.3 per 100,000 [95% confidence interval (CI) 5.4, 7.2] for in situ and 10.1 per 100,000 (95% CI 9.0, 11.3) for invasive melanoma. Since the mid-1990s, incidence rates for in situ melanomas have been stabilizing while invasive melanoma has decreased in both sexes, mainly owing to declining rates of thin tumours (≤1 mm) (−5.4% per year, 95% CI −8.3%, −2.4%). Incidence rates of melanomas >1 mm in thickness have remained relatively unchanged since 1991 however. In the period 2006–2010, relative 5-year survival of 15–24 year olds with invasive melanoma was 95.7% (95% CI 92.9%, 97.5%). The subgroup with tumours >1 mm was nearly six times more likely to die within 5 years than those with thin tumours (adjusted hazard ratio = 5.53, 95% CI 1.72, 17.80). Incidence of thin melanoma in young people in Queensland is declining, suggesting benefits of primary prevention efforts are being realised.What's new?Although some of the highest known incidence rates ofcutaneous melanoma are found in Queensland, Australia, few studies have examined incidence specifically among 15- to 24-year-olds in the state. This evaluation shows that the incidence of invasive melanoma is relatively high for the 15- to 24-year-old age group. However, incidence rates were found to have declined generally among Queensland's adolescents and young adults since the mid- to late 1990s. The decline may be a reflection of successful primary prevention efforts in young people in recent decades.

Epidemiology of Melanoma

“…Among high-risk populations, melanoma incidence will likely continue to rise in the geriatric subpopulation (6). However, incidence trends among younger individuals are hopeful, with some trends stagnating and some even decreasing in high-risk populations (19,58,103). In high melanoma incidence nations like Australia, melanoma rates have largely stabilized (9,19).…”

“…Queensland, a predominately tropical state in Australia (latitude 27°S) has higher melanoma rates than New South Wales (latitude 34°S) (24,57,58). An inverse latitude gradient is observed in Europe (59).…”

Mobile Teledermatology is a Valid Method to Estimate Prevalence of Melanocytic Naevi in Children

“…More than 3 decades of intense public campaigning for better sun protection has not yet given but few indications for a visible reduction of cutaneous malignant melanoma (CMM) incidence (1)(2)(3). A less latent variable for validating the effects of sun preventive actions is by studying numbers of common melanocytic naevi (CMN) in children.…”

Prevention: Lessons from a sunburnt country

“…But after decades of increase, the melanoma rate began to plateau in the mid 1990s 1 . The incidence of melanoma among young people is now falling 1,2 , as national surveys show that most Australians -more than 70% of adults and 55% of adolescents -no longer prefer a tan 3 .…”