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Stage-specific incidence trends of melanoma in an English region, 1996–2015

longitudinal analyses of population-based data

Herbert, Anniea; Koo, Minjoung M.a; Barclay, Matthew E.b,c; Greenberg, David C.b; Abel, Gary A.d; Levell, Nick J.e; Lyratzopoulos, Georgiosa,b,c

doi: 10.1097/CMR.0000000000000489
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The aim of this study was to examine temporal trends in overall and stage-specific incidence of melanoma. Using population-based data on patients diagnosed with melanoma in East Anglia, England, 1996–2015, we estimated age-standardized time trends in annual incidence rates for each stage at diagnosis. Negative binomial regression was used to model trends over time adjusted for sex, age group and deprivation, and to subsequently examine variation in stage-specific trends by sex and age group. The age-standardized incidence increased from 14 to 29 cases/100 000 persons (i.e. 4% annually). Increasing incidence was apparent across all stages but was steepest for stage I [adjusted annual increase: 5%, 95% confidence interval (CI): 5–6%, and more gradual for stage II–IV disease (stage II: 3%, 95% CI: 2–4%; stage III/IV: 2%, 95% CI: 1–3%)]. Stage II–IV increase was apparent in men across age groups and in women aged 50 years or older. Increases in incidence were steeper in those aged 70 years or older, and in men. The findings suggest that both a genuine increase in the incidence of consequential illness and a degree of overdiagnosis may be responsible for the observed increasing incidence trends in melanoma in our population during the study period. They also suggest the potentially lower effectiveness of public health awareness campaigns in men and older people.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/

aDepartment of Behavioural Sciences and Health, Epidemiology of Cancer Healthcare and Outcomes Research Group, University College London, London

bPublic Health England National Cancer Registration and Analysis Service, Fulbourn

cThe Health Improvement Studies Institute & Cambridge Centre for Health Services Research, University of Cambridge, Cambridge

dPrimary Care, University of Exeter Medical School, Exeter

eDepartment of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK

Correspondence to Georgios Lyratzopoulos, MD, Department of Behavioural Science and Health, Epidemiology of Cancer Healthcare and Outcomes Research Group, University College London, WC1E 7HB London, UK Tel: +44 206 798 267; fax: +44 207 679 8354; e-mail: y.lyratzopoulos@ucl.ac.uk

Received December 10, 2017

Accepted June 29, 2018

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