Skin cancer incidence statistics

Malignant melanoma is the 5th most common cancer in the UK (2010), accounting for 4% of all new cases. Malignant melanoma is the 6th most common cancer among men in the UK, accounting for 4% of all new cases of cancer in males. It is also the 6th most common cancer among women in the UK, responsible for 4% of all new cases of cancer in females.

In 2010, there were 12,818 new cases of malignant melanoma in the UK (Table 1.1): 6,201 (48%) in men and 6,617 (52%) in women, giving a male: female ratio of around 10:11.1-4 The crude incidence rate shows that there are around 20 new malignant melanoma cases for every 100,000 males in the UK and around 21 for every 100,000 females.

European age-standardised incidence rates (AS rates) of malignant melanoma are significantly higher in Wales compared with England, Scotland and Northern Ireland (males only). They are also significantly lower in Northern Ireland compared with Wales, England and Scotland (males only) (Table 1.1). Rates for women are similar across all the constituent countries of the UK.1-4

Table 1.1: Malignant Melanoma (C43), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2010

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*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

The Cancer Atlas for the UK and Ireland 1991-2000, which analysed rates at local authority and health board level, showed that male and female melanoma incidence rates have a very similar geographical distribution. The highest rates for both sexes occur in south west England and for the densely populated belt from Glasgow in the west to Edinburgh in the east of Scotland, illustrated for men in Figure 1.1.5

Similarly the latest analysis of malignant melanoma incidence rates across the cancer networks throughout the UK reports modest variation, with the exception of the rates for areas in the south and south west England regions which are significantly higher than most other cancer networks. The incidence rates for areas of London are significantly lower than all other cancer networks.6.7

Figure 1.1: Malignant Melanoma (C43), Incidence by Health Authority, Males, UK and Ireland, 1991-1999

section reviewed 24/07/12
section updated 24/07/12

Malignant melanoma incidence is related to age, but it has an unusual pattern when compared with most other cancer sites. An average of 27% of new malignant melanoma cases diagnosed in the UK between 2008 and 2010 were in those aged under 50 years, with an average of 45% of cases diagnosed in people aged 65 years and over (Figure 1.2).1-4 This is in contrast to all cancers combined (excluding non-melanoma skin cancer) where between 2008 and 2010 11% of cases were diagnosed in those aged under 50, and 63% of cases were diagnosed in those aged 65 years and over.

Age-specific incidence rates increase steadily from 20-24 years onwards reaching a peak at age 85+ years for both sexes, although for males there is a sharper increase in the incidence rate from age 55-59 years. Incidence rates are higher in females than males in younger ages, with a male:female ratio of 4:10 in 20-24 year-olds. However, males have higher rates from age 55-59 years onwards: the male: female ratio increases with age more prominently in older age groups, from around 11:10 at age 60-64 years, to around 16:10 at age 85+ years.

Figure 1.2: Malignant Melanoma (C43), Average Number of New Cases Per Year and Age-Specific Incidence Rates, UK, 2008-2010

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section reviewed 24/07/12
section updated 24/07/12

Malignant melanoma incidence rates have overall increased in Great Britain since the mid 1970s (Figure 1.3).1-4 For men, European AS incidence rates were around seven times higher in 2008-2010 than in 1975-1977. For women the increase is smaller but rates have quadrupled between 1975-1977 and 2008-2010. During this last thirty year period, incidence rates of malignant melanoma in Great Britain have increased more rapidly than any of the current ten most common cancers in males and females.

Some of the increase may be due to increased surveillance and early detection as well as changes in diagnostic criteria, but most is considered to be real and linked to changes in sun-related behaviour such as an increase in frequency of holidays abroad over time.8-11 A study published in December 2011 estimated that around 86% of malignant melanomas in the UK in 2010 were linked to exposure to UVR from the sun and sunbeds.12

Figure 1.3: Malignant Melanoma (C43), European Age-Standardised Incidence Rates, Great Britain, 1975-2010

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Malignant melanoma incidence trends for the UK are shown in Figure 1.4.1-4 Incidence rates in the UK increased sharply from 2000 onwards, increasing by 55% from around 11 cases per 100,000 population in 1999-2001 to around 17 cases per 100,000 population in 2008-2010.

Figure 1.4: Malignant Melanoma (C43), European Age-Standardised Incidence Rates, UK, 1993-2010 

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Malignant melanoma incidence rates have increased across all age groups for males (Figure 1.5) between 1975-1977 and 2008-2010.1-3 The largest overall increase has been for males aged 60-79 years where incidence rates are around ten times higher than they were in the mid 1970s, with more than 5 cases per 100,000 males in 1975-1977 to around 54 cases per 100,000 males in 2008-2010.

Figure 1.5: Malignant Melanoma (C43), Trends in European Age-Standardised Incidence Rates, Males by Age, Great Britain, 1975-2010

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Malignant melanoma incidence rates have also increased across all age groups for females (Figure 1.6) between 1975-1977 and 2008-2010.1-3 Following a similar pattern to males, the largest overall increase has been for females also aged 60-79 years, where incidence rates have increased more than five-fold from more than 7 cases per 100,000 females in 1975-1977 to around 40 cases per 100,000 females in 2008-2010.

Figure 1.6: Malignant Melanoma (C43), Trends in European Age-Standardised Incidence Rates, Females by Age, Great Britain, 1975-2010 

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For each of these age groups the increase has been faster for males than females.

Malignant melanoma incidence rates have also increased across all age groups overall (Figure 1.7) between 1975-1977 and 2008-2010.1-3 As indicated by males and female rates, the largest overall increase has been for people also aged 60-79 years, where incidence rates have increased around seven-fold from more than 6 cases per 100,000 population in 1975-1977 to around 47 cases per 100,000 population in 2008-2010. Rates for those aged 50-59 years have more than tripled over the last 30 years going from more than 7 cases per 100,000 population in 1979-1981, to more than 26 cases per 100,000 population.

Figure 1.7: Malignant Melanoma (C43), Trends in European Age-Standardised Incidence Rates, Persons by Age, Great Britain, 1975-2010

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section reviewed 01/08/12
section updated 01/08/12

Lifetime risk is an estimation of the risk that a newborn child has of being diagnosed with cancer at some point during their life. It is a summary of risk in the population but genetic and lifestyle factors affect the risk of cancer and so the risk for every individual is different.

In 2010, in the UK, the lifetime risk of developing malignant melanoma is 1 in 55 for men and 1 in 56 for women.29

The lifetime risk for malignant melanoma cancer has been calculated by the Statistical Information Team using the ‘Adjusted for Multiple Primaries’ (AMP) method; this accounts for the possibility that someone can have more than one diagnosis of malignant melanoma cancer over the course of their lifetime.30
 

section reviewed 25/04/13
section updated 25/04/13

Figure 1.8 shows the percentage distribution of malignant melanoma on parts of the body. These vary by sex, with more than four in ten cases in males arising on the trunk of the body, particularly the back; while the most common site for females is on the legs.14

Figure 1.8: Malignant Melanoma (C43), Percentage Distribution of Cases Diagnosed on Parts of the Body, by Sex, Great Britain, 2008-2010

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Note: percentages may not add due to rounding

section reviewed 24/07/12
section updated 24/07/12

The Tumour, Node, Metastasis (TNM) staging is based on the tumour size, whether the cancer had spread to nearby nodes or whether it had spread more widely around the body with TNM stage 1 being the least and TNM stage 4 being the most developed. For the purpose of the analysis, TNM stages 1 and 2 were combined to form 'early' stage and combined TNM stages 3 and 4 for 'late' stage. 

Data for this specific analysis on late stage malignant melanoma by age from 1997-2008 were requested from Eastern Cancer Registry and Information Centre (ECRIC) in 2010 and showed that significantly more people aged 65 and over were diagnosed with malignant melanoma at a late stage than those under 65.15 In recent years (between 2006-2008), 7% of 15-64 year olds diagnosed with malignant melanoma were at a late stage compared with around 20% of those aged over 65 (Figure 1.9). There were only 2% of malignant melanoma tumours where the actual TNM stage at diagnosis was not known. The regional data from ECRIC were used because, at present, good quality consistent staging data are unavailable nationally. 

Figure 1.9: Percentage of people diagnosed* with late** stage Malignant Melanoma (C43), by Age, Persons, ECRIC Region 1997-2008

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*excluding unknowns
**‘late stage’ malignant melanoma in this analysis refers to those at stage 3 or 4

section reviewed 29/06/12
section updated 29/06/12

Although cancer registration has a long history in many countries of the world, particularly in the more affluent regions such as the UK, nearly 80% of the world’s populations live in regions that are not covered by such systems.16 Nonetheless, with a view to characterising the global burden of the disease, the International Agency for Research on Cancer routinely uses the available data to estimate worldwide cancer incidence.17

Malignant melanoma is the 19th most common cancer worldwide, estimated to be responsible for almost 200,000 new cases of cancer in 2008 (more than 1% of the total). Malignant melanoma incidence rates are highest in Australia/New Zealand and lowest in South-Central Asia, with around a 200-fold variation in World AS incidence rates between the regions of the world for males, and around a 160-fold variation for females (Figure 1.9).17

The majority of malignant melanomas are caused by heavy sun exposure in white-skinned populations.18,19 Incidence rates are highest by far in Australia/New Zealand (37 per 100,000 in 2008), where it is the third most common cancer in both males and females, accounting for one in nine (around 11% in 2008) of the total cases.17 Incidence rates are increasing rapidly in many countries, including in the Nordic countries, where the increase has been attributed to excessive sun exposure during holidays at lower latitudes.18

Figure 1.9: Malignant Melanoma (C43), World Age-Standardised Incidence Rates, World Regions, 2008 Estimates

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Within the 27 countries of the European Union (EU-27), the highest malignant melanoma European AS incidence rates are estimated to be in Sweden for males (around 22 cases per 100,000) and Denmark for females (around 26 cases per 100,000), and the lowest rates are estimated to be in Greece for both sexes (more than 3 male cases per 100,000, and around 3 female cases per 100,000) (Figure 1.10).20

Figure 1.10: Malignant Melanoma (C43), European Age-Standardised Incidence Rates, EU-27 Countries, 2008 Estimates

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UK malignant melanoma incidence rates are estimated to be the 7th and 6th highest in males and females, respectively in Europe (EU-27).20

section reviewed 29/06/12
section updated 29/06/12

Malignant melanoma incidence is strongly related to deprivation but in the opposite way to that seen for most cancers, with a clear trend of increasing incidence rates with decreasing levels of deprivation i.e. the affluent are more likely to get melanoma. The most recent England-wide data for 2000-2004 shows European AS incidence rates are around 120% higher for men living in the most deprived areas compared with the least deprived, and 120% higher for women.21 It has been estimated that there would have been an additional 2,000 new malignant melanoma cancer cases each year in England during 2000-2004 if all men and women had experienced the same rates as the most affluent.21

 A study in Scotland for 2005-2009 showed that the gap between the affluent and the deprived for malignant melanoma is slightly lower than that seen for England, with people in the least deprived quintiles having around 75% higher rates, compared with the most deprived.22 Similar/comparable associations with deprivation have also been reported in Wales and Northern Ireland.23,24

Risk factors associated with malignant melanoma such as sun exposure and sunbed use are discussed in detail on the skin cancer risk factors page.

section reviewed 29/06/12
section updated 29/06/12

Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not. The latest estimates for the UK (Table 1.2) show that nearly 60,000 men and women were still alive at the end of 2006, up to ten years after being diagnosed with malignant melanoma.25 Worldwide, it is estimated that there were around 756,000 cancer patients still alive in 2008, up to five years after their diagnosis.17

Table 1.2: Malignant Melanoma (C43), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

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section reviewed 29/06/12
section updated 29/06/12

Non-melanoma skin cancer (NMSC) is an extremely common cancer, but relatively few deaths are caused by it. In 2010, there were 99,549 cases of NMSC registered in the UK1-4, but these figures are known to be under-estimates because the recording of NMSC is known to be incomplete.26

With 56% of cases diagnosed in males, and 82% of NMSCs occurring in people aged 60 and over at diagnosis, they constitute a substantial burden to the national health services across the UK because of the large number of cases diagnosed each year.

The majority of NMSCs are either basal cell carcinomas (BCCs), also known as rodent ulcers, or squamous cell carcinomas (SCCs). Both forms are highly treatable and survival rates for NMSCs are very high.27 However, if left untreated, these tumours can become destructive, invading local tissues and causing disfigurement.28

section reviewed 31/07/12
section updated 31/07/12