Melanoma on the decline in parts of Australia

The incidence of invasive melanoma has been declining in Victorians aged under 55 but is still climbing in those aged 55 years or more, although at a slower rate than before the mid-1990s, according to research published today by the Medical Journal of Australia.

Researchers from the University of Sydney, the Royal North Shore Hospital, and the Peter MacCallum Cancer Centre in Melbourne analysed data from the Victorian Cancer Registry on Victorian residents diagnosed with melanoma between 1985 and 2015.

They found that the incidence of invasive melanoma in Victoria in 2015 was 52.9 cases per 100 000 men and 39.2 cases per 100 000 women. Since the mid-1990s, the incidence for men increased by 0.9% per year, but for women there was no significant change. The incidence of invasive melanoma has been declining in age groups under 55 since 1996, but is still increasing in those over 55. The most frequent sites of tumours in men were on the trunk (40%), in women on the upper (32%) and lower limbs (31%).

“The difference [between men and women] is largely attributable to the higher incidence in older men,” David Curchin and his co-authors wrote.

“Since the mid-1990s, the increase in the incidence of invasive melanoma has slowed in both sexes; in women, the rate has plateaued. The incidence remains higher in more northerly states, but the trends are similar to those in other Australian states and for Australia overall.

“A promising finding was the declining incidence in people under 55 years of age of both sexes, with annual decreases since the mid-1990s of 1.4% for men and 1.9% for women.

“These results attest to the effectiveness of skin cancer prevention campaigns since the early 1980s, such as the Slip! Slop! Slap! and SunSmart campaigns,” the investigators noted.

“Given the long latency between excessive sun exposure and the clinical presentation of melanoma, the first observable changes attributable to primary prevention campaigns would have reasonably been expected in the mid-1990s.

“Skin cancer prevention campaigns also promote early detection, and the slowing increase in the incidence of invasive melanoma may also indicate that more melanomas are being diagnosed while still in situ.”

Despite the positive results, complacency was “not appropriate”, the authors concluded.

“Melanoma remains a significant health problem in Victoria, and its incidence is still increasing in older people. Less encouraging is that the proportion of thicker tumours remains steady and therefore, despite recent progress in systemic therapies, continues to be a problem. The higher rates of thicker tumours in older people show the importance of early detection in these patients, and this should be the focus of public awareness campaigns.”

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