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The future incidence of cutaneous melanoma within the U.K.


B. L. Diffey.


Background  The incidence of cutaneous malignant melanoma continues to rise in the U.K., where since the 1970s malignant melanoma has seen the largest increase in incidence rates compared with other major cancers. To counteract this rise, sun awareness campaigns have been introduced in this and several other countries since the 1980s with the object of encouraging people to limit their exposure to strong sunshine and to avoid sunburn in the expectation that these interventions will act favourably on skin cancer incidence.

Objectives  To predict the incidence of cutaneous malignant melanoma in the British population over the next half-century as a consequence of either a stabilization or a reduction in lifetime risk of melanoma for recent and future birth cohorts so that cancer services can be planned appropriately over the coming years.

Methods  An age-cohort model has been developed that estimates future incidence rates of melanoma in the U.K.

Results  The results suggest that the benefits of intervention strategies, assuming that these will translate eventually into a downturn in melanoma incidence, may not be seen for another 30 years or so, by which time the predicted age-standardized rate of melanoma may be around twice that presently observed.

Conclusions  Prevention of deaths from melanoma depends on both reducing incidence and achieving earlier diagnosis. This analysis has indicated that the former is unlikely to be realized in the U.K. for some decades, and so early detection of suspected lesions, with prompt surgery to remove confirmed tumours, is paramount if mortality from melanoma is to be kept in check.