Skin cancer incidence statistics

Malignant melanoma is the fifth most common cancer in the UK (2012), accounting for 4% of all new cases. In males and females separately, malignant melanoma is the sixth most common cancer (4% each of the male and female total).[1-4]

In 2012, there were 13,497 new cases of malignant melanoma in the UK: 6,602 (49%) in men and 6,895 (51%) in women, giving a male: female ratio of around 10:10.[1-4] The crude incidence rate Open a glossary item shows that there are 21 new malignant melanoma cases for every 100,000 males in the UK and 21 for every 100,000 females.

The European age-standardised rates Open a glossary item (AS rates) are significantly higher in males in England and Wales than in females. [1-4] The rates do not differ significantly between the constituent countries of the UK or between males and females in Scotland and Northern Ireland.

Malignant Melanoma (C43), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2012

England Wales Scotland Northern Ireland UK
Male Cases 5,535 367 549 151 6,602
Crude Rate 21.0 24.3 21.3 16.9 21.1
AS Rate 24.8 26.4 24.7 22.6 24.8
AS Rate - 95% LCL 24.2 23.7 22.6 19.0 24.2
AS Rate - 95% UCL 25.5 29.1 26.8 26.2 25.4
Female Cases 5,746 326 628 195 6,895
Crude Rate 21.2 20.8 22.9 21.0 21.3
AS Rate 22.0 20.5 23.0 23.0 22.0
AS Rate - 95% LCL 21.4 18.3 21.2 19.7 21.5
AS Rate - 95% UCL 22.6 22.7 24.7 26.2 22.5
Persons Cases 11,281 693 1,177 346 13,497
Crude Rate 21.1 22.5 22.2 19.0 21.2
AS Rate 23.0 23.1 23.4 22.3 23.0
AS Rate - 95% LCL 22.6 21.4 22.0 19.9 22.6
AS Rate - 95% UCL 23.4 24.8 24.7 24.6 23.4

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS Rate. Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

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 malignant melanoma incidence rates have a very similar geographical distribution. The highest rates for both sexes occur in south west England and in the densely populated belt of Scotland, from Glasgow in the west to Edinburgh in the east.[5]

Similarly the latest analysis of malignant melanoma incidence rates across the former cancer networks throughout the UK reports significantly higher rates in the south and south west regions of England, whilst the incidence rates for areas of London are significantly lower than all other cancer networks.[6,7] The lower rates in London reflect the higher proportions of people from non-white ethnic groups, in whom melanoma risk is lower.[8]

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
  5. Quinn M, Wood H, Cooper N, et al, eds. Cancer Atlas of the United Kingdom and Ireland 1991–2000 Studies on Medical and Population Subjects No. 68. London: ONS; 2005.
  6. National Cancer Intelligence Network (NCIN). Cancer Incidence and Mortality by Cancer Network, UK, 2005. London: NCIN; 2008.
  7. National Cancer Intelligence Network (NCIN). Cancer e-Atlas
  8. Office for National Statistics. 2011 Census, Key Statistics for Local Authorities in England and Wales.
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Malignant melanoma incidence is related to age, but it has an unusual pattern when compared with most other cancer types. In the UK between 2010 and 2012, an average of 26% of cases were diagnosed in those aged under 50 years, and an average of 25% of cases were diagnosed in the 75s and over.[1-4] This is in contrast to all cancers combined (excluding non-melanoma skin cancer), where 11% of cases were diagnosed in those aged under 50 during the same period, and 36% of cases were diagnosed in those aged 75 years and over.

Age-specific incidence rates increase steadily from around age 20-24 years, reaching a peak at age 90+ for males, and at age 85-59 years for females. The increase is sharper for males from age 55-59 years onwards, with a slight drop in rates from 85-89 years to 90+ in females. Incidence rates are higher for females than for males in the younger age groups: the difference is largest at age 20-24, when the male:female incidence ratio of age-specific incidence rates (to account for the different proportions of males to females in each age group) is 4:10. However, males have higher incidence rates from age 60-64 onwards, and the male:female ratio of age-specific rates increases with age, from around 12:10 at age 60-64 years, to more than 19:10 at age 90+ years.

Malignant Melanoma (C43), Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Population, UK, 2010-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
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Malignant melanoma incidence rates have increased overall in Great Britain since the late-1970s.[1-3] For males, European age-standardised Open a glossary item (AS) incidence rates increased by more than six-fold (518% increase) between 1979-1981 and 2010-2012. This rise is smaller for females, with rates having increased by more than triple (253% increase) between 1979-1981 and 2012. Since the late-1970s in Great Britain, malignant melanoma incidence rates 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.[4-7] 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.[8]

Malignant Melanoma (C43), European Age-Standardised Incidence Rates per 100,000 Population, by Sex, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

Over the last decade (between 2001-2003 and 2010-2012) the European AS incidence rates in the UK have increased by 62% and 38% in males and females, respectively.[1-3,9]

Malignant Melanoma (C43), European Age-Standardised Incidence Rates per 100,000 Population, by Sex, UK, 1993-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

Malignant melanoma incidence rates have increased overall for all of the broad age groups in Great Britain since the late-1970s.[1-3] The largest increases have been in people aged 70-79, with European AS incidence rates increasing more than six-fold between 1979-1981 and 2010-2012. Incidence rates for those aged 80+ have also increased around six-fold (502% increase) over the same time period.

Malignant Melanoma (C43), European Age-Standardised Incidence Rates per 100,000 Population, by Age, Persons, Great Britain, 1975-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080
  4. Dennis LK. Analysis of the melanoma epidemic, both apparent and real: data from the 1973 through 1994 surveillance, epidemiology, and end results program registry. Arch Dermatol 1999;135(3):275-80.
  5. de Vries E, Coebergh JW. Cutaneous malignant melanoma in Europe. Eur J Cancer 2004;40(16):2355-66.
  6. de Vries E, Coebergh JW. Melanoma incidence has risen in Europe. BMJ 2005; 331(7518):698.
  7. Office for National Statistics. Travel Trends 2005. A report on the International Passenger Survey. London: ONS; 2006.
  8. Parkin DM, Mesher D, Sasieni P. Cancers attributable to solar (ultraviolet) radiation exposure in the UK in 2010. Brit J Cancer 2011;105 (S2):S66-S69.
  9. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
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Staging completeness for skin cancer is high in England, with 86% of skin cancers recorded with a known stage at diagnosis in 2013.[1]

Malignant Melanoma (C43), Proportion of Cases Diagnosed at Each Stage, England 2013

People diagnosed with skin cancer with a known stage most commonly present at stage I (72%), in England. More people with a known stage are diagnosed at an early stage (91% diagnosed at stage I or II) than an advanced stage (9% diagnosed at stage III or IV). Just 3% of people have metastases Open a glossary item at diagnosis (stage IV).[1]

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The lifetime risk of developing malignant melanoma is 1 in 52 for men and 1 in 54 for women, in 2012 in the UK.[1]

The lifetime risk for malignant melanoma has been calculated to account for the possibility that someone can have more than one diagnosis of malignant melanoma over the course of their lifetime (‘Adjusted for Multiple Primaries’ (AMP) method).[2]

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on data provided by the Office of National Statistics, ISD Scotland, the Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry, on request, December 2013 to July 2014.
  2. Sasieni PD, Shelton J, Ormiston-Smith N, et al. What is the lifetime risk of developing cancer?: The effect of adjusting for multiple primaries. Br J Cancer, 2011. 105(3): p. 460-5.
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In males, the largest proportion of malignant melanoma cases occur in the trunk, with smaller proportions in the head and neck, and much smaller proportions in the arms and legs (2010-2012).[1-4]

In females, the largest proportion of malignant melanoma cases occurs in the legs, with smaller proportions in the arms, trunk and head and neck (2010-2012).[1-4]

The proportions of cases in the trunk and head and neck are higher in males (41.0% and 23.4%, respectively) than females (19.8% and 14.0%, respectively). In the legs and arms, the proportions are higher in females (38.4% and 25.1%, respectively) than males (13.4% and 18.8%, respectively).[1-4]

A small proportion of cases did not have the specific part of the body recorded in cancer registry data, or overlapped more than one part.[1-4]

Malignant Melanoma (C43), Percentage Distribution of Cases Diagnosed By Anatomical Site, by Sex, UK, 2010-2012

Male Female
Cancer site (ICD-10 code) Average Cases % Average Cases %
Head and Neck (C43.0-C43.4) 1,508 23.4% 950 14.0%
Trunk (C43.5) 2,639 41.0% 1,349 19.8%
Arms (C43.6) 1,208 18.8% 1,711 25.1%
Legs (C43.7) 861 13.4% 2,613 38.4%
Skin, Overlapping and Unspecified (C43.8-C43.9) 224 3.5% 182 2.7%
Total 6,440 100.0% 6,805 100.0%

Cases and percentages may not sum due to rounding

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:
    http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/CancerInformation/.
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Malignant melanoma is the ninth most common cancer in Europe, with more than 100,000 new cases diagnosed in 2012 (3% of the total). In Europe (2012), the highest World age-standardised Open a glossary item incidence rates for malignant melanoma are in Switzerland for men and Denmark for women; the lowest rates are in Albania for both men and women. UK malignant melanoma incidence rates are estimated to be the ninth highest in males in Europe, and seventh highest in females.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

Malignant melanoma is the 19th most common cancer worldwide, with around 232,000 new cases diagnosed in 2012 (2% of the total). Malignant melanoma incidence rates are highest in Australia/New Zealand and lowest in South Central Asia, but this partly reflects varying data quality worldwide.[1]

Variation between countries may reflect different prevalence of risk factors, use of screening, and diagnostic methods.

References

  1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed December 2013.
  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403.
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Malignant melanoma incidence is strongly inversely related to deprivation in the UK; it is one of the few cancers where incidence rates are lower for more deprived men and women and there is a clear trend of decreasing rates from the least to the most deprived.[1-4] The most recent England-wide data for 2000-2004 show European age standardised (AS) incidence rates are 122% higher for men living in the least deprived areas compared with the most deprived, and 116% higher for women.[1] 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 incidence rates as the most affluent.[1]

A study in Scotland for 2006-2010 showed that the gap in malignant melanoma incidence by deprivation is slightly smaller, with the least deprived people having 81% higher rates, compared with the most deprived.[2] Comparable associations with deprivation have also been reported in Wales and Northern Ireland.[3,4]

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

References

  1. National Cancer Intelligence Network (NCIN). Cancer incidence by deprivation England, 1995-2004 (PDF 1.04MB). London: NCIN; 2008.
  2. ISD Scotland. Cancer Statistics. Cancer of the Skin. Accessed July 2013.
  3. Welsh Cancer Intelligence and Surveillance Unit. Cancer in Wales, 1995-2009: A Comprehensive Report. Cardiff: WCISU; 2011.
  4. Donnelly DW, Gavin AT, Comber H. Cancer in Ireland 1994-2004: A comprehensive report. Ireland: Northern Ireland Cancer Registry/National Cancer Registry, Ireland; 2009.
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Age-standardised Open a glossary item rates for White males with malignant melanoma range from 13.1 to 13.6 per 100,000. Rates for Asian males are significantly lower, ranging from 0.2 to 0.8 per 100,000 and the rates for Black males are also significantly lower, ranging from 0.6 to 2.6 per 100,000. For females there is a similar pattern - the age-standardised rates for White females range from 14.7 to 15.2 per 100,000, and rates for Asian and Black females are also significantly lower ranging from 0.2 to 1.1 per 100,000 and 1.0 to 3.6 per 100,000 respectively.[1]

Ranges are given because of the analysis methodology used to account for missing and unknown data. For malignant melanoma, 38,097 cases were identified; 36% had no known ethnicity.

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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.

In the UK around 59,000 people were still alive at the end of 2006, up to ten years after being diagnosed with malignant melanoma.[1]

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

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 4,278 16,118 24,617
Female 5,132 21,203 34,530
Persons 9,410 37,321 59,147

Worldwide, it is estimated that there were nearly 756,000 men and women still alive in 2008, up to five years after their diagnosis.[2]

References

  1. National Cancer Intelligence Network (NCIN). One, Five and Ten Year Cancer Prevalence by Cancer Network UK, 2006. London: NCIN; 2010.
  2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2. Cancer Incidence and Mortality Worldwide: IARC Cancerbase No.10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr. Accessed May 2011.
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Non-melanoma skin cancers (NMSC) are extremely common, but relatively few deaths are caused by them. In 2012, there were 98,368 cases of NMSC registered in the UK:[1-4] 55,525 (56%) in men and 42,843 (44%) in women, giving a male:female ratio of around 13:10.[1-4]

The majority of NMSCs are  basal cell carcinomas Open a glossary item  (BCCs, 74%) or squamous cell carcinomas Open a glossary item (SCCs, 23%).[5] The remainder comprises a mixed group of rare skin cancers; almost three in ten of these are Merkel cell carcinoma, which has a very poor prognosis.[6]

Both BCC and SCC are more common in males than females, though the sex difference is wider for SCC than BCC.[5] The recorded incidence of BCC increased by around a third (36% in males and 32% in females) between 2000-2002 and 2008-2010 in England, Scotland, Northern Ireland and Ireland combined.[5] SCC incidence increased by a similar amount (34% in males and 39% in females) over the same time period.[5] Whilst improved registration may partly explain these increases, some of the increase is probably genuine, reflecting increased UV exposure from the sun or sunbeds.[5]

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April. Similar data can be found here:http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/CancerData/OnlineStatistics/
  5. National Cancer Intelligence Network (NCIN). Non-melanoma skin cancer in England, Scotland, Northern Ireland, and Ireland. London: NCIN; 2013.
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