Abstract
Background: The overall incidence of melanoma has increased steadily for several years. The relative change in incidence at different ages has not been fully described. Objective: To describe how incidence at different ages has changed over time and to consider what aspects of tumour biology may explain the observed pattern of change in incidence. Methods: The slope of incidence vs age measures the acceleration of cancer incidence with age. We described the pattern of change over time in the overall incidence of melanoma, as well as in acceleration. We used data for males and females from 3 different countries in the 17 sequential 5-year birth-cohort categories from 1895-99 to 1975-79, from which we derived the incidence patterns. Results: Over time, there has been a tendency for the overall incidence of melanoma to increase and for the acceleration (slope) of the age-incidence curves to decline. The changing patterns of melanoma incidence and acceleration differ between males and females and between the countries analysed. Conclusions: The observed pattern in melanoma of rising incidence and declining acceleration occurs in other cancers in response to genetic knockouts of mechanisms that protect against cancer. Perhaps some protective mechanism with respect to melanoma may be less effective now than in the past, possibly because of more intense environmental challenges.
Highlights
The incidence of malignant melanoma has increased steadily over the past 50 years in predominately fair-skinned populations[1]
By analysing the 17 sequential 5-year birth cohorts from 1895–99 to 1975–79, we show that incidence has increased steadily over time
To quantify the age-incidence relationship and its change over time, we study the rate of change of melanoma incidence with age[4,5,6], which is the acceleration of cancer[7]
Summary
The incidence of malignant melanoma has increased steadily over the past 50 years in predominately fair-skinned populations[1]. By analysing the 17 sequential 5-year birth cohorts from 1895–99 to 1975–79, we show that incidence has increased steadily over time. We described the pattern of change over time in the overall incidence of melanoma, as well as in acceleration. We used data for males and females from 3 different countries in the 17 sequential 5-year birth-cohort categories from 1895-99 to 1975-79, from which we derived the incidence patterns. Results: Over time, there has been a tendency for the overall incidence of melanoma to increase and for the acceleration (slope) of the age-incidence curves to decline. The changing patterns of melanoma incidence and acceleration differ between males and females and between the countries analysed. Conclusions: The observed pattern in melanoma of rising incidence and declining acceleration occurs in other cancers in response to genetic knockouts of mechanisms that protect against cancer. Perhaps some protective mechanism with respect to melanoma may be less effective than in the past, possibly because of more intense environmental challenges
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