Trends in Skin Melanoma Burden

Findings From the Global Burden of Disease Study

Charalampos Siotos, MD; Miles W Grunvald, MD; George Damoulakis, MS; Adan Z Becerra, PhD; Cristina M O'Donoghue, MD, MPH; Amir H Dorafshar, MD; Deana S Shenaq, MD

Disclosures

ePlasty. 2022;22(e9) 

In This Article

Abstract and Introduction

Abstract

Background: Melanoma is the third most common skin cancer and the leading cause of skin cancer mortality. This study sought to investigate trends in melanoma incidence, mortality, and burden of disease.

Methods: The authors assessed the records of the Global Burden of Disease Study 2017 to extract information about the incidence, mortality, and disability adjusted life years (DALY) related to melanoma during 1990–2017 in the US and other countries based on their socio-demographic index (SDI).

Results: Melanoma incidence in the US increased 1.6 times, although the difference was not statistically significant. For patients over the age of 60, the incidence was significantly increased by 1.72 to 164.6 times. Mortality was relatively stable during the study period; however, it was increased for patients over 65 years of age (range: 1.03 to 70 times), although not statistically significant. Mortality-to-incidence ratio was decreased, but the difference was not statistically significant. For patients over 75 years of age, DALYs were statistically significantly increased by 1.34 to 1.71 times.

Conclusions: This study highlights differences in melanoma incidence and mortality from 1990–2017. Physicians involved in melanoma care should be aware of these changes in order to anticipate care needs.

Introduction

Cutaneous melanoma is a cancer of the skin caused by unchecked proliferation of the melanin-producing cells (melanocytes) of the dermis. Melanoma is the third most common skin cancer and the leading cause of skin cancer mortality.[1] Amongst the population with the highest risk for melanoma, males of older age with fair skin, it is believed that the mortality rate has increased over time.[2]

Much research has been conducted on the burden of melanoma, which is a particularly relevant topic given the increasing incidence.[3] The Global Disease Burden study of 2015 demonstrated 351,880 cases worldwide (incidence of ~5 of 100,000), with the highest incidences of melanoma occurring in Australasia and North America.[4] Beyond the incidence of melanoma, many reports have attempted to identify years of life lost (YLL), disability adjusted life years (DALYs), and economic loss associated with this cancer.[5] Research focused specifically in North America has demonstrated 1,800,000 YLLs accrued over an 18-year period accounting for $66.9 billion in economic productivity loss.[6] Despite this proliferation of information on the burden of melanoma there remains a paucity of synthesized information regarding trends on a global scale and information related to population socioeconomic status and melanoma burden.

The past several decades have been marked by large changes in the treatment and prevention of melanoma care worldwide. Beginning in the 1980s, there have been many public health initiatives to improve the prevention and detection of melanoma, most notably the "Slip! Slop! Slap!" campaign of Australia.[7] The 1990s and 2000s were marked by the advent and adoption of sentinel lymph node biopsy and clinical trials that advanced surgical care, with the Multicenter Selective Lymphadenectomy Trials (MSLT-1 and MSLT-2) and Dermatologic Cooperative Oncology Group trial (DeCOG) being some of the most important.[8,9] Finally, over the past several years there have been innovations in the use of immunotherapies for the treatment of Stage 3 and 4 melanoma.[10,11] Assessing the data for trends in burden of disease will provide insight into the global effects of the aforementioned interventions. Further, assessment of recent data will set a baseline as new therapies are developed and become widely available.

This study aims to utilize the Global Disease Burden database to evaluate the trend of melanoma incidence, DALYs, mortality, and mortality-to-incidence ratio (M/I) between 1990 and 2017. Further, it compares melanoma burden and mortality based on global socioeconomic status. This study hyphothesizes an increase in melanoma incidence and a decrease in DALYs and mortality. Information on trends of the global burden of melanoma may provide insight to areas requiring focused intervention.

processing....