Trends in incidence of malignant melanoma in the elderly (aged 65+ years) in England, 1971–2010

Background: Malignant melanoma is the 5th most common cancer in the UK. Over the past four decades, incidence rates of malignant melanoma have increased more than for any other common cancer. The highest incidence rates are observed in the elderly aged 65+ years [accounting for about half (49%) of all cases]. Aim: To determine trends in incidence of malignant melanoma in the elderly in England during the period 1971–2010. Methods: Population-based national cancer registration data were analysed to determine the incidence of malignant melanoma (ICD-9: 172; ICD-10: C43) by age (65–69, 70–74, 75–79, 80–84, and 85+), gender, morphological sub-type and anatomical site of tumour. Results: During the 40-year period, a total of 69,496 cases of malignant melanoma among the elderly aged 65+ years were registered in England (44.7% males, 55.3% females). The total number of cases increased from 2,023 in 1971-75 (405 cases/year) to 21,132 in 2006-10 (4,226 cases/year). The incidence rate (per 100,000) increased from 5.1 in 1971-75 to 61.4 in 2006-10 in males (12-fold increase); and from 7.0 to 42.6 in females (6-fold increase). The majority of cases (95.3%) were diagnosed by histology. The most common morphological sub-type was superficial spreading melanoma (24.5%); and in 2006-10, the most common anatomical site was ‘trunk’ (35.2%) in males and ‘lower limb’ (38.8%) in females. During the study period, the largest increase in incidence rate, according to anatomical site, was observed for ‘trunk’ (534-fold) in males and ‘lower limb’ (17-fold) in females. Conclusions: During the past four decades, there has been a remarkable increase in the incidence of malignant melanoma among the elderly in England. The largest increase was observed in the malignant melanoma involving the ‘trunk’ in males. Considering that an estimated 86% of malignant melanoma cases in the UK are linked to the ultraviolet radiation from the sun, effective lifestyle and behaviour change education could have an enormous impact on primary prevention and reducing the incidence of the disease. The findings are also relevant for the organisation and commissioning of oncology services and resource allocation.