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Summary

Background  National melanoma incidence trends with details of anatomical site have not been previously described for England.

Objectives  To describe site-specific trends in cutaneous melanoma for England as a whole during the last three decades.

Methods  Anonymized data, 1979–2006, were obtained from national cancer registrations of all patients in England up to age 89 years with incident primary invasive cutaneous melanomas (= 124 055). Sex-specific age-standardized incidence rates and average annual percentage change in rates were calculated for each broad anatomical site.

Results  Overall incidence rates of cutaneous melanoma in England, 1979–2006, were 81 and 100 per million, in males and females, respectively. Site-specific rates were consistently highest on the lower limbs in females followed by the trunk in males. Greatest annual increases occurred on the trunk in both sexes over 45 years (males 9·9%, females 6·8%), then upper limbs (males 8·7%, females 6·8%). Incidence trends in males relative to females varied little across sites apart from a more rapid rise in head/neck melanomas in males than in females after the 1980s.

Conclusions  Invasive melanoma rates continue to rise in England, particularly on the trunk and arms, and in males on the head/neck. The steeper increases in melanoma rates among males are consistent with their greater sun exposure and poorer compliance with sun protection measures than females.