Trend Shifts in Age-Specific Incidence for In Situ and Invasive Cutaneous Melanoma in Sweden
Abstract
:Simple Summary
Abstract
1. Introduction
2. Results
2.1. Annual Age-Standardised Incidence, 1997–2018
2.1.1. In Situ Cutaneous Melanomas
2.1.2. Invasive Cutaneous Melanomas
2.2. Incidence Trends of In Situ and Invasive Cutaneous Melanomas by Tumour Thickness
2.2.1. In Situ Cutaneous Melanomas
2.2.2. Invasive Cutaneous Melanomas
2.3. Incidence Trends of Invasive Cutaneous Melanomas by Age
3. Discussion
4. Patients and Methods
Statistical Analysis
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Clinico-Pathological Characteristics | All CM N (%) | CM in Women N (%) | CM in Men N (%) |
---|---|---|---|
In situ CM | 35,350 | 18,110 (51.2) | 17,240 (48.8) |
Age (median IQR) | 67.0 (55.0; 76.0) | 65.0 (52.0; 75.0) | 69.0 (59.0; 77.0) |
Age group | |||
<50 years | 6585 (18.6) | 4220 (23.3) | 2365 (13.7) |
50–70 years | 14,413 (40.8) | 7200 (39.8) | 7213 (41.8) |
>70 years | 14,352 (40.6) | 6690 (36.9%) | 7662 (44.4) |
Invasive CM | 59,932 | 29,503 (49.2) | 30,429 (50.8) |
Age (median IQR) | 65.0 (51.0; 75.0) | 62.0 (48.0; 75.0) | 67.0 (55.0; 76.0) |
Age group (years) | |||
<50 | 14,100 (23.5) | 8607 (29.2) | 5493 (18.1) |
50–70 | 23,866 (39.8) | 11,104 (37.6) | 12,762 (41.9) |
>70 | 21,965 (36.7) | 9792 (33.2) | 12,173 (40.0) |
Breslow tumour thickness (mm; median IQR) | 0.90 (0.50; 2.00) | 0.8(0.5; 1.70) | 1.00 (0.5; 2.2) |
Ulceration status | |||
Absent | 42,895 (71.6) | 21,471 (72.8) | 21,424 (70.4) |
Present | 10,702 (17.9) | 4749 (16.1) | 5953 (19.6) |
Missing | 6335 (10.6) | 3283 (11.1) | 3052 (10.0) |
Histopathologic subtype | |||
SSM | 36,649 (61.2) | 18,445 (62.5) | 18,204 (59.8) |
NM | 4100 (6.8) | 2024 (6.86) | 2076 (6.82) |
LM | 9548 (15.9) | 4194 (14.2) | 5354 (17.6) |
ALM | 667 (1.1) | 402 (1.4) | 265 (0.9) |
Other | 7281 (12.1) | 3590 (12.2) | 3691 (12.1) |
Missing | 1687 (2.8) | ||
T-stage | |||
TX | 2015 (3.4) | 1055 (3.6) | 960 (3.2) |
T1 | 2032 (3.4) | 1117 (3.8) | 915 (3.0) |
T1a | 21,352 (35.6) | 11,118 (37.7) | 10,234 (33.6) |
T1b | 9450 (15.8) | 4755 (16.1) | 4695 (15.4) |
T2 | 1046 (1.8) | 540 (1.8) | 506 (1.7) |
T2a | 8298 (13.8) | 4017 (13.6) | 4281 (14.1) |
T2b | 2046 (3.4) | 990 (3.4) | 1056 (3.5) |
T3 | 622 (1.0) | 281 (1.0) | 341 (1.4) |
T3a | 3674 (6.1) | 1699 (5.8) | 1975 (6.5) |
T3b | 3260 (5.4) | 1365 (4.6) | 1895 (6.2) |
T4 | 408 (0.68) | 167 (0.6) | 241 (0.8) |
T4a | 1796 (3.0) | 743 (2.5) | 1053 (3.5) |
T4b | 3933 (6.6) | 1656 (5.6) | 2277 (7.5) |
(a) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
All Ages | Women | ||||||||||||
1997–2018 | Period 1 | Y | Period 2 | ||||||||||
AAPC | LCL | UCL | p-Value | APC1 | LCL | UCL | p-Value | APC2 | UCL | LCL | p-Value | ||
Tumour Thickness | |||||||||||||
All | 4.5 | 4.1 | 5.0 | <0.001 | - | - | - | - | - | - | - | - | |
≤0.6 | 5.4 | 4.5 | 6.3 | <0.001 | 2.9 | 0.8 | 5.1 | 0.009 | 2005 | 7.0 | 6.2 | 7.7 | <0.001 |
0.7 | 4.4 | 2.6 | 6.2 | <0.001 | −1.0 | −6.6 | 5.0 | 0.724 | 2003 | 6.6 | 5.4 | 7.8 | <0.001 |
0.8 | 5.7 | 4.3 | 7.0 | <0.001 | - | - | - | - | - | - | - | - | - |
0.9 | 3.8 | 2.7 | 4.8 | <0.001 | - | - | - | - | - | - | - | - | - |
1.0 | 2.5 | 1.5 | 3.5 | <0.001 | - | - | - | - | - | - | - | - | - |
1.1–2.0 | 3.6 | 2.8 | 4.4 | <0.001 | - | - | - | - | - | - | - | - | - |
2.1–4.0 | 2.9 | 1.9 | 3.9 | <0.001 | 4.5 | 3.4 | 5.5 | <0.001 | 2011 | −0.1 | −2.4 | 2.2 | 0.904 |
>4 | 4.6 | 3.5 | 5.6 | <0.001 | 7.7 | 5.1 | 10.4 | <0.001 | 2005 | 2.6 | 1.8 | 3.5 | <0.001 |
Missing | 2.5 | −0.0 | 5.1 | 0.053 | 8.4 | 4.8 | 12.1 | <0.001 | 2009 | −4.9 | −8.9 | −0.6 | 0.027 |
In situ | 10.0 | 9.4 | 10.5 | <0.001 | - | - | - | - | - | - | - | - | - |
All Ages | Men | ||||||||||||
1997–2018 | Period 1 | Y | Period 2 | ||||||||||
AAPC | LCL | UCL | p-Value | APC1 | LCL | UCL | p-Value | APC2 | LCL | UCL | p-Value | ||
Tumour Thickness | |||||||||||||
All | 4.2 | 3.0 | 5.4 | <0.001 | −0.4 | −8.4 | 8.3 | 0.920 | 2000 | 5.0 | 4.6 | 5.4 | <0.001 |
≤0.6 | 6.3 | 5.2 | 7.4 | <0.001 | 3.2 | 0.9 | 5.5 | 0.009 | 2006 | 8.7 | 7.7 | 9.8 | <0.001 |
0.7 | 6.4 | 4.2 | 8.7 | <0.001 | 5.0 | 3.7 | 6.4 | <0.001 | 2015 | 15.2 | 0.4 | 32.2 | 0.044 |
0.8 | 5.6 | 4.8 | 6.4 | <0.001 | - | - | - | - | - | - | - | - | - |
0.9 | 4.4 | 3.4 | 5.5 | <0.001 | - | - | - | - | - | - | - | - | - |
1.0 | 3.3 | 1.6 | 5.0 | <0.001 | - | - | - | - | - | - | - | - | - |
1.1–2.0 | 3.9 | 3.3 | 4.5 | <0.001 | - | - | - | - | - | - | - | - | - |
2.1–4.0 | 2.1 | 1.1 | 3.2 | <0.001 | 3.4 | 2.3 | 4.5 | <0.001 | 2011 | −0.4 | −2.8 | 2.1 | 0.753 |
>4 | 3.4 | 2.8 | 4.0 | <0.001 | - | - | - | - | - | - | - | - | |
Missing | 2.3 | −0.6 | 5.3 | 0.119 | 6.7 | 2.7 | 11.0 | 0.003 | 2009 | −3.3 | −8.0 | 1.6 | 0.168 |
In situ | 10.2 | 8.8 | 11.6 | <0.001 | 2.4 | −2.6 | 7.7 | 0.334 | 2002 | 12.8 | 11.9 | 13.7 | <0.001 |
(b) | |||||||||||||
Age Group: <50 | Women | ||||||||||||
1997–2018 | Period 1 | Y | Period 2 | ||||||||||
AAPC | LCL | UCL | p-Value | APC1 | LCL | UCL | p-Value | AAPC | LCL | UCL | p-Value | ||
Tumour Thickness | |||||||||||||
All | 3.3 | 1.9 | 4.8 | <0.001 | 4.4 | 3.6 | 5.2 | <0.001 | 2015 | –2.9 | –11. | 6.7 | 0.513 |
≤0.6 | 4.8 | 4.1 | 5.4 | <0.001 | - | - | - | - | - | - | - | - | - |
0.7 | 3.7 | 2.3 | 5.2 | <0.001 | - | - | - | - | - | - | - | - | - |
0.8 | 1.5 | –5.6 | 9.2 | 0.680 | 5.5 | 3.0 | 8.1 | <0.001 | 2016 | –29.4 | –68.1 | 55. | 0.366 |
0.9 | 3.8 | 2.1 | 5.5 | <0.001 | - | - | - | - | - | - | - | - | - |
1.0 | 1.1 | –0.8 | 3.1 | 0.247 | - | - | - | - | - | - | - | - | - |
1.1–2.0 | 2.8 | 1.4 | 4.2 | <0.001 | - | - | - | - | - | - | - | - | - |
2.1–4.0 | 3.7 | 2.5 | 4.9 | <0.001 | - | - | - | - | - | - | - | - | - |
>4 | 2.2 | –0.1 | 4.7 | 0.061 | - | - | - | - | - | - | - | - | - |
Missing | 1.4 | –3.2 | 6.4 | 0.552 | 7.6 | 3.1 | 12. | 0.002 | 2012 | –12.6 | –24.2 | 0.8 | 0.063 |
Age Group: <50 | Men | ||||||||||||
1997–2018 | Period 1 | Y | Period 2 | ||||||||||
AAPC | LCL | UCL | p-Value | APC1 | LCL | UCL | p-Value | AAPC | LCL | UCL | p-Value | ||
Tumour Thickness | |||||||||||||
All | 3.1 | 2.5 | 3.6 | <0.001 | - | - | - | - | - | - | - | - | - |
≤0.6 | 4.4 | 3.3 | 5.6 | <0.001 | - | - | - | - | - | - | - | - | - |
0.7 | 4.1 | 2.4 | 5.8 | <0.001 | - | - | - | - | - | - | - | - | - |
0.8 | 2.9 | 1.2 | 4.7 | 0.002 | - | - | - | - | - | - | - | - | - |
0.9 | 2.5 | 0.9 | 4.0 | 0.002 | - | - | - | - | - | - | - | - | - |
1.0 | 2.4 | 0.8 | 4.0 | 0.005 | - | - | - | - | - | - | - | - | - |
1.1–2.0 | 2.3 | 1.1 | 3.5 | 0.001 | - | - | - | - | - | - | - | - | - |
2.1–4.0 | 0.8 | –0.4 | 2.1 | 0.200 | - | - | - | - | - | - | - | - | - |
>4 | 0.1 | –1.6 | 1.9 | 0.886 | - | - | - | - | - | - | - | - | - |
Missing | 0.9 | –4.73 | 6.9 | 0.749 | 10.6 | 1.9 | 20.2 | 0.019 | 2008 | –8.76 | –16.9 | 0.2 | 0.055 |
(c) | |||||||||||||
Age Group: 50–70 | Women | ||||||||||||
1997–2018 | Period 1 | Y | Period 2 | ||||||||||
AAPC | LCL | UCL | p-Value | APC1 | LCL | UCL | p-Value | AAPC | LCL | UCL | p-Value | ||
Tumour Thickness | |||||||||||||
All | 4.8 | 3.6 | 6.0 | <0.001 | 1.3 | −1.5 | 4.1 | 0.344 | 2005 | 7.0 | 6.0 | 8.1 | <0.001 |
≤0.6 | 5.1 | 3.5 | 6.7 | <0.001 | - | - | - | - | - | - | - | - | - |
0.7 | 5.7 | 4.2 | 7.3 | <0.001 | - | - | - | - | - | - | - | - | - |
0.8 | 2.6 | 1.5 | 3.8 | <0.001 | - | - | - | - | - | - | - | - | - |
0.9 | 2.6 | 1.3 | 3.9 | <0.001 | - | - | - | - | - | - | - | - | - |
1.0 | 3.6 | 2.7 | 4.6 | <0.001 | - | - | - | - | - | - | - | - | - |
1.1–2.0 | 2.5 | 1.3 | 3.7 | <0.001 | - | - | - | - | - | - | - | - | - |
2.1–4.0 | 2.7 | 1.4 | 4.1 | <0.001 | - | - | - | - | - | - | - | - | - |
>4 | 1.8 | −2.9 | 6.9 | 0.449 | 8.2 | 2.2 | 14. | 0.010 | 2010 | −7.6 | −16.4 | 1.9 | 0.108 |
Missing | 3.9 | 2.9 | 5.0 | <0.001 | 2.0 | −0.7 | 4.9 | 0.144 | 2004 | 4.9 | 4.1 | 5.7 | <0.001 |
Age Group: 50–70 | Men | ||||||||||||
1997–2018 | Period 1 | Y | Period 2 | ||||||||||
AAPC | LCL | UCL | p-Value | APC1 | LCL | UCL | p-Value | AAPC | LCL | UCL | p-Value | ||
Tumour Thickness | |||||||||||||
All | 5.8 | 4.7 | 6.9 | <0.001 | 3.7 | 1.4 | 6.1 | 0.003 | 2006 | 7.4 | 6.3 | 8.5 | <0.001 |
≤0.6 | 4.4 | 2.1 | 6.7 | <0.001 | −0.3 | −5.6 | 5.2 | 0.909 | 2005 | 7.4 | 5.3 | 9.4 | 0.000 |
0.7 | 4.8 | 3.6 | 6.0 | <0.001 | - | - | - | - | - | - | - | - | - |
0.8 | 3.4 | 2.0 | 4.8 | <0.001 | - | - | - | - | - | - | - | - | - |
0.9 | 2.2 | 0.3 | 4.1 | 0.023 | - | - | - | - | - | - | - | - | - |
1.0 | 3.6 | 2.9 | 4.3 | <0.001 | - | - | - | - | - | - | - | - | - |
1.1–2.0 | 1.8 | 0.9 | 2.7 | <0.001 | - | - | - | - | - | - | - | - | - |
2.1–4.0 | 2.2 | 1.2 | 3.2 | <0.001 | - | - | - | - | - | - | - | - | - |
>4 | 1.4 | −1.16 | 4.0 | 0.267 | - | - | - | - | - | - | - | - | - |
Missing | 4.1 | 3.7 | 4.6 | <0.001 | - | - | - | - | - | - | - | - | - |
(d) | |||||||||||||
Age Group: >70 | Women | ||||||||||||
1997–2018 | Period 1 | Y | Period 2 | ||||||||||
AAPC | LCL | UCL | p-Value | APC1 | LCL | UCL | p-Value | AAPC | LCL | UCL | p-Value | ||
Tumour Thickness | |||||||||||||
All | 5.5 | 5.0 | 6.0 | <0.001 | - | - | - | - | - | - | - | - | - |
≤0.6 | 8.2 | 7.1 | 9.3 | <0.001 | - | - | - | - | - | - | - | - | - |
0.7 | 7.8 | 6.0 | 9.7 | <0.001 | - | - | - | - | - | - | - | - | - |
0.8 | 6.3 | 1.4 | 11. | 0.010 | 9.2 | 7.0 | 11.5 | <0.001 | 2016 | −17.9 | −49.8 | 34. | 0.410 |
0.9 | 5.8 | 4.1 | 7.6 | <0.001 | - | - | - | - | - | - | - | - | - |
1.0 | 3.9 | 2.3 | 5.5 | <0.001 | - | - | - | - | - | - | - | - | - |
1.1–2.0 | 4.2 | 3.4 | 5.1 | <0.001 | - | - | - | - | - | - | - | - | - |
2.1–4.0 | 3.0 | 2.1 | 4.0 | <0.001 | - | - | - | - | - | - | - | - | - |
>4 | 5.2 | 3.8 | 6.6 | <0.001 | 7.6 | 4.6 | 10. | <0.001 | 2006 | 3.4 | 2.1 | 4.8 | <0.001 |
Missing | 2.3 | 0.0 | 4.7 | 0.043 | - | - | - | - | - | - | - | - | - |
Age Group: >70 | Men | ||||||||||||
1997–2018 | Period 1 | Y | Period 2 | ||||||||||
AAPC | LCL | UCL | p-Value | APC1 | LCL | UCL | p-Value | AAPC | LCL | UCL | p-Value | ||
Tumour Thickness | |||||||||||||
All | 5.7 | 5.3 | 6.1 | <0.001 | - | - | - | - | - | - | - | - | - |
≤0.6 | 6.9 | 4.2 | 9.6 | <0.001 | −6.1 | −18.2 | 7.6 | 0.340 | 2001 | 10.2 | 9.1 | 11.4 | <0.001 |
0.7 | 8.3 | 6.1 | 10.6 | <0.001 | 6.0 | 4.5 | 7.6 | <0.001 | 2015 | 23.2 | 7.9 | 40.7 | 0.004 |
0.8 | 8.0 | 6.2 | 9.7 | <0.001 | - | - | - | - | - | - | - | - | - |
0.9 | 6.5 | 4.6 | 8.4 | <0.001 | - | - | - | - | - | - | - | - | - |
1.0 | 4.6 | 1.8 | 7.4 | 0.002 | - | - | - | - | - | - | - | - | - |
1.1–2.0 | 4.8 | 3.8 | 5.8 | <0.001 | - | - | - | - | - | - | - | - | - |
2.1–4.0 | 2.7 | 1.9 | 3.5 | <0.001 | - | - | - | - | - | - | - | - | - |
>4 | 4.1 | 3.3 | 5.0 | <0.001 | - | - | - | - | - | - | - | - | - |
Missing | 2.5 | 0.4 | 4.6 | 0.018 | - | - | - | - | - | - | - | - | - |
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Eriksson, H.; Nielsen, K.; Vassilaki, I.; Lapins, J.; Mikiver, R.; Lyth, J.; Isaksson, K. Trend Shifts in Age-Specific Incidence for In Situ and Invasive Cutaneous Melanoma in Sweden. Cancers 2021, 13, 2838. https://doi.org/10.3390/cancers13112838
Eriksson H, Nielsen K, Vassilaki I, Lapins J, Mikiver R, Lyth J, Isaksson K. Trend Shifts in Age-Specific Incidence for In Situ and Invasive Cutaneous Melanoma in Sweden. Cancers. 2021; 13(11):2838. https://doi.org/10.3390/cancers13112838
Chicago/Turabian StyleEriksson, Hanna, Kari Nielsen, Ismini Vassilaki, Jan Lapins, Rasmus Mikiver, Johan Lyth, and Karolin Isaksson. 2021. "Trend Shifts in Age-Specific Incidence for In Situ and Invasive Cutaneous Melanoma in Sweden" Cancers 13, no. 11: 2838. https://doi.org/10.3390/cancers13112838