General decline in death rates from skin cancer in Scotland over past two decades

A UK study published on THE LANCET's website today—www.thelancet.com—shows an increased five-year survival from invasive skin cancer for men and women in Scotland, and a reduced yearly death rate from the disease among women, despite an overall increase in the incidence of melanoma over the past two decades. Authors of the study highlight the need for public-health programmes to try and reduce the incidence of skin cancer in western populations. The incidence of skin cancer is increasing steadily in many parts of the world. Rona MacKie from the University of Glasgow, UK, and colleagues aimed to assess the incidence and survival for all patients with invasive skin cancer (malignant melanoma) diagnosed in Scotland between 1979 and 1998. Data were obtained by the Scottish Melanoma Group for 8830 patients diagnosed with invasive cutaneous malignant melanoma. Melanoma incidence increased from 3.5 in 1979 to 10.6 per 100,000 population in 1998 for men, and from 7 to around 13 for women—rises of around 300% and just under 200%, respectively.

Among men, melanoma incidence increased most on the trunk, head, and neck and in women on the leg. Five-year survival increased from 58% to 80% for men diagnosed in 1979 and 1993, respectively, and from 74% to 85% for women. The overall male death-rate from melanoma was 1.9/100,000 population per year at the start and end of the study, whereas mortality for men younger than 65 years at diagnosis rose from 1.2 to 1.35. For all women, the death rate from skin cancer decreased from 1.9 to 1.85/100,000 population per year, whereas for women younger than 65 years at diagnosis, mortality fell from 1.3 to 1.15.

Rona MacKie comments: "Our data shows that while the number of people in Scotland who develop melanoma is increasing each year, they appear to be recognising that they have a problem and are seeking treatment at an earlier stage. This explains the fact that mortality from melanoma has changed very little over the past 20 years. We still need to encourage a change in sun-exposure behaviour which, over a period of time, should lead to a reduction in melanoma incidence." (quote by e-mail; does not appear in published paper).

Contact: Professor Rona MacKie, Department of Dermatology, University of Glasgow, Glasgow G12 8QQ, UK; T) +44 (0)141 955 0320; F +44 (0)141 955 0696; E) R.M.MacKie@clinmed.gla.ac.uk

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