Melanoma Incidence and Mortality Trends in Sweden.

IF 11.5 1区医学 Q1 DERMATOLOGY JAMA dermatology Pub Date : 2024-09-08 DOI:10.1001/jamadermatol.2024.3514

Hildur Helgadottir, Rasmus Mikiver, Karina Schultz, Kari Nielsen, Francesca Portelli, Jan Lapins, Susana Puig, Karolin Isaksson

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Abstract

Importance: Over the past decades, many global regions have experienced a steady increase in the incidence of cutaneous melanoma. However, more recently, a downward trend has been observed in the younger age groups in Australia and the US. Yet, in Europe, none of the countries have reported any significant decline in melanoma incidence for any age group.

Objective: To assess melanoma incidence and mortality trends in Sweden, with a focus on individuals younger than the average age of melanoma onset.

Design, setting, and participants: This cohort study used data on the national population from the Swedish Melanoma Registry and the Swedish Cancer Registry, which cover more than 99% of all primary invasive cutaneous melanomas diagnosed in the country. All patients diagnosed from 1990 to 2022 were included.

Main outcomes and measures: Incidence and mortality rates per 100 000 inhabitants were calculated for each year and shown as average annual rates for every 5-year period from 1990 to 2022. Joinpoint regression models were used to evaluate statistical significance of temporal trends and points of change.

Results: There were 34 800 primary invasive cutaneous melanomas (19 582 [56.3%] in females and 15 218 [43.7%] in males) reported in 33 324 individuals younger than 60 years (median [IQR] age, 48 [36-58] years) from 1990 to 2022. A consistent rise in melanoma incidence was observed among those 50 to 59 years old. The age groups from 20 to 29 years, 30 to 39 years, and 40 to 49 years showed an incidence peak in 2013 to 2015 followed by stable or significantly declining rates until 2022. In patients younger than 20 years, melanoma incidence remained low with no significant trends. There was also a significant decline in melanoma mortality among 30- to 59-year-old individuals, but not in those 60 years and older.

Conclusions and relevance: The findings of this cohort study showed a significant recent downward trend in both melanoma incidence and melanoma mortality in the age group 30 to 49 years in Sweden. The reasons for these declines are unclear but may include UV protection, public health campaigns, changing population demographics, and the introduction of effective melanoma treatment. None of these possibilities were evaluated; further study is needed.

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瑞典黑色素瘤发病率和死亡率趋势。

重要性：过去几十年来，全球许多地区的皮肤黑色素瘤发病率持续上升。不过，最近在澳大利亚和美国，年轻群体的发病率呈下降趋势。然而，在欧洲，没有一个国家报告任何年龄组的黑色素瘤发病率有明显下降：评估瑞典的黑色素瘤发病率和死亡率趋势，重点关注低于黑色素瘤平均发病年龄的人群：这项队列研究使用了瑞典黑色素瘤登记处和瑞典癌症登记处的全国人口数据，这两个登记处涵盖了瑞典99%以上的原发性侵袭性皮肤黑色素瘤患者。1990年至2022年期间确诊的所有患者均被纳入其中：计算每年每 10 万居民的发病率和死亡率，并以 1990 年至 2022 年每 5 年的平均年率表示。采用连接点回归模型来评估时间趋势和变化点的统计意义：从 1990 年到 2022 年，在 33 324 名年龄小于 60 岁的人（中位数[IQR]年龄为 48 [36-58] 岁）中，共报告了 34 800 例原发性侵袭性皮肤黑色素瘤（女性为 19 582 [56.3%] 例，男性为 15 218 [43.7%] 例）。在 50 至 59 岁的人群中，黑色素瘤发病率持续上升。20至29岁、30至39岁和40至49岁年龄组的发病率在2013年至2015年达到高峰，随后保持稳定或显著下降，直至2022年。在20岁以下的患者中，黑色素瘤的发病率仍然很低，没有明显的趋势。30至59岁人群的黑色素瘤死亡率也明显下降，但60岁及以上人群的黑色素瘤死亡率没有明显下降：这项队列研究的结果表明，瑞典 30 至 49 岁年龄组的黑色素瘤发病率和黑色素瘤死亡率近期均呈显著下降趋势。下降的原因尚不清楚，但可能包括紫外线防护、公共卫生运动、人口结构变化以及引入有效的黑色素瘤治疗方法。对这些可能性都没有进行评估；需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JAMA dermatology DERMATOLOGY-

CiteScore

14.10

自引率

5.50%

发文量

300

期刊介绍： JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery. JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications. It is published online weekly, every Wednesday, and in 12 print/online issues a year. The mission of the journal is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, with the aim of enabling dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care. The journal publishes a broad range of innovative studies and trials that shift research and clinical practice paradigms, expand the understanding of the burden of dermatologic diseases and key outcomes, improve the practice of dermatology, and ensure equitable care to all patients. It also features research and opinion examining ethical, moral, socioeconomic, educational, and political issues relevant to dermatologists, aiming to enable ongoing improvement to the workforce, scope of practice, and the training of future dermatologists. JAMA Dermatology aims to be a leader in developing initiatives to improve diversity, equity, and inclusion within the specialty and within dermatology medical publishing.

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