Review date
March 2024
Article publication date
February 2024
Summary
The study analysed historic incidence and mortality data related to cutaneous malignant melanoma between 1980 and 2020. Data analysis was performed for each eligible country and was further divided by gender and age group, one age group between 20-44 years and another age group between 45-64 years.
Globally, from the 2005-2009 period to the 2015-2019 period it was found that mortality has generally declined in both age groups except for a few countries that displayed an increase in mortality rates. Global incidence was either static or trending upwards. The authors primarily attribute recent notable declines in mortality to advances made in melanoma treatments since approximately 2010.
Incidence in Australia was found to be declining in the 20-44 age bracket and stable in the 45-64 age bracket. The comparatively promising incidence trends in Australia were attributed to prevention programs, effective control of UV exposure and an increased use in high-quality sunscreens. It was further shown that the mortality rate in Australia has declined by 41.7% among men and 47.9% among women in the 20-44 age bracket and in the 45-64 age bracket the mortality rate has also declined by 22.9% among men and 25.5% among women.
The study also identifies a gender difference, with women globally recording higher incidence rates but lower mortality rates than their male counterparts. The authors suggested greater health care awareness in female patients as a potential reason. The unreliable distinction between melanoma and non-melanoma skin cancer on death certificates in most countries was highlighted as a source of bias for older populations.
Published in
Melanoma Research
Link to
Global trends in cutaneous malignant melanoma incidence and mortality
ARPANSA commentary
This study collated data on melanoma incidence and mortality rates in a variety of countries and highlighted a recent downward trend in melanoma mortality rates in many countries including Australia. This downward mortality trend is also seen in data provided by the Cancer Council. While the study details favourable trends for Australia, including a falling incidence rate where many other countries are reporting a rising incidence rate, it should be noted that the actual values of melanoma incidence and mortality rates in Australia remain some of the highest in the world, exceeding the rates found in some other countries by multiple times.
Skin cancers, including melanoma, are one of the largest public health concerns in Australia with two-thirds of Australians receiving a skin cancer diagnosis of some type in their lifetime. For melanoma specifically, it is estimated that 1 in 21 Australian women and 1 in 14 Australian men will be diagnosed with melanoma by the time they reach the age of 85 (Australian Institute of Health and Welfare 2023). The largest risk factor for melanoma is overexposure to ultraviolet radiation (UVR) from the sun, with as many as 95% of all melanomas being attributed to UVR overexposure (Whiteman et al. 2015, Armstrong & Kricker 1993).
ARPANSA recommends following the five sun protection principles when the UV-index is over three. ARPANSA administers and maintains UVR monitoring stations across Australia that can be used to see the UVR index in real time across Australia and make informed decisions about sun protection. More information about the risks of sun exposure and methods of sun protection can be found from: The World Health Organization, The Cancer Council of Australia and SunSmart websites.
