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. 2023 May;98(5):713-722.
doi: 10.1016/j.mayocp.2022.10.029.

Increasing Incidence and Decreasing Mortality of Cutaneous Melanoma in Middle-Aged Adults: An Epidemiologic Study in Olmsted County, Minnesota

Elliott H Campbell  1 , Jacob P Reinhart  2 , Olivia M Crum  2 , Sydney L Proffer  2 , Amy Weaver  3 , Lawrence E Gibson  4 , Jerry D Brewer  5 , Addison M Demer  5
Affiliations

Increasing Incidence and Decreasing Mortality of Cutaneous Melanoma in Middle-Aged Adults: An Epidemiologic Study in Olmsted County, Minnesota

Elliott H Campbell et al. Mayo Clin Proc. 2023 May.

Abstract

Objective: To identify changes in the incidence and mortality of cutaneous melanoma in the fastest-growing segment of the US population, middle-aged adults.

Patients and methods: Using the Rochester Epidemiology Project, patients aged 40 to 60 years with a first lifetime diagnosis of cutaneous melanoma between January 1, 1970, and December 31, 2020, while a resident of Olmsted County, Minnesota, were identified.

Results: A total of 858 patients with a primary cutaneous first-time melanoma were identified. The overall age- and sex-adjusted incidence rate increased from 8.6 (95% CI, 3.9 to 13.3) per 100,000 person-years in 1970-1979 to 99.1 (95% CI, 89.5 to 108.7) per 100,000 person-years in 2011-2020 (11.6-fold increase). There was a 52.1-fold increase in women and a 6.3-fold increase in men between these 2 periods. In recent years (2005-2009 vs 2015-2020), the incidence has stabilized in men (1.01-fold increase; P=.96) and continues to significantly increase in women (1.5-fold increase; P=.002). Among 659 patients with invasive melanoma, 43 deaths were due to melanoma, and male sex was significantly associated with an increased risk of death (hazard ratio, 2.95; 95% CI, 1.45 to 6.00). A more recent diagnosis of melanoma was significantly associated with a decreased risk of death due to melanoma (hazard ratio, 0.66 per 5-year increase in calendar year of diagnosis; 95% CI, 0.59 to 0.75).

Conclusion: Melanoma incidence has significantly increased since 1970. During the past 15 years, the incidence has continued to rise in middle-aged women (approximately 50% rise in incidence) but has stabilized in men. Mortality decreased in a linear fashion throughout this time.

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Conflict of interest statement

Conflict of interest (all authors): None declared

Figures

Figure 1.
Figure 1.
(A) Age-adjusted incidence of cutaneous melanoma per 100,000 person-years in Olmsted County, Minnesota, 1970–2020, for persons 40–60 years of age, by gender and calendar period. (B) Age- and sex-specific incidence of melanoma per 100,000 person-years. Bars represent 95% Confidence intervals.
Figure 2
Figure 2
Hazard ratio (HR) for the risk of death due to melanoma according to (A) calendar year of diagnosis, (B) age at diagnosis, and (C) Breslow depth, with each analysis centered such that the HR is 1.0 at calendar year of 2000, age of 50 years, and Breslow depth of 1 mm, respectively. To address the wide 95% confidence bands (dashed lines) in the distributions’ tails, calendar years during 1970–1979 were combined as 1979 and Breslow depths >4 were combined as 4 for this illustration.
Figure 3.
Figure 3.
Cause-specific survival according to (A) calendar decade of diagnosis, (B) pathologic stage, and (C) Breslow depth, respectively, among patients with invasive melanoma.
See this image and copyright information in PMC

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