CUTANEOUS MALIGNANT-MELANOMA IN SCOTLAND - INCIDENCE, SURVIVAL, AND MORTALITY, 1979-94

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.