Rm. Mackie et al., CUTANEOUS MALIGNANT-MELANOMA IN SCOTLAND - INCIDENCE, SURVIVAL, AND MORTALITY, 1979-94, BMJ. British medical journal, 315(7116), 1997, pp. 1117-1121
Objective: To determine the changing incidence of and mortality from c
utaneous malignant melanoma in Scotland from 1979 to 1994. Design: Det
ailed registration of clinical and pathological features, surgical and
other treatment, and follow up of all cases of cutaneous malignant me
lanoma diagnosed from 1979 to 1994 and registered with specialist data
base for Scotland. Setting: Scotland. Subjects: 6288 patients with inv
asive primary cutaneous malignant melanoma diagnosed between 1 January
1979 and 31 December 1994. Results: The annual age standardised incid
ence of cutaneous malignant melanoma rose significantly from 3.5 to 7.
8 per 100 000 per year in men and from 6.8 to 12.3 per 100 000 per yea
r in women (P < 0.001 for both). World standardised rates increased fr
om 2.7 to 6.0 per 100 000 per year in men and 4.6 to 8.50 per 100 000
in women. The incidence of melanoma continued to increase significantl
y in men of all ages during the study but the rate stabilised in women
after 1986. Mortality from cutaneous malignant melanoma was 1.3 per m
illion per annum in men in 1979, rising to 2.3 per million per annum i
n 1994 (P < 0.01); it was 2.4 per million per annum in women in 1979,
falling to 1.9 per million per annum in 1994 (P = 0.09). The underlyin
g mortality trends showed a continuing rise for men but a downward tre
nd for women that was not significant (P = 0.09). In men, melanoma fre
e survival was 69% at 5 years and 61% at 10 years; in women the corres
ponding rates were 82% and 75%. Younger patients had higher survival r
ates, which were not entirely explained by thinner rumours. Over the 1
5 year period, survival rates improved by 12% overall, only partly owi
ng to thinner tumours. Conclusions: In Scotland the incidence of melan
oma in women has stabilised, while mortality associated with melanoma
in women shows a downward trend.