Trends in Invasive Melanoma Thickness in Norway, 1983–2019

Raju Rimal; Trude E. Robsahm; Adele C. Green; Reza Ghiasvand; Corina S. Rueegg; Assia Bassarova; Petter Gjersvik; Elisabete Weiderpass; Odd O. Aalen; Bjørn Møller; Flavie Perrier; Marit B. Veierød

doi:10.2340/actadv.v104.26110

Authors

Raju Rimal Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway https://orcid.org/0000-0001-6097-0285
Trude E. Robsahm Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway https://orcid.org/0000-0002-1652-7734
Adele C. Green Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Cancer Research UK Manchester Institute, University of Manchester, Manchester, United Kingdom https://orcid.org/0000-0002-2753-4841
Reza Ghiasvand Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway; Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway https://orcid.org/0000-0002-5466-7308
Corina S. Rueegg Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway https://orcid.org/0000-0003-3720-4659
Assia Bassarova Department of Pathology, Oslo University Hospital – Ullevål, Oslo, Norway https://orcid.org/0000-0002-3707-691X
Petter Gjersvik Department of Dermatology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway https://orcid.org/0000-0002-3596-9829
Elisabete Weiderpass International Agency for Research on Cancer, Lyon, France https://orcid.org/0000-0003-2237-0128
Odd O. Aalen Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo https://orcid.org/0000-0002-9451-4832
Bjørn Møller Department of Registration, Cancer Registry of Norway, Oslo, Norway https://orcid.org/0000-0002-4770-1889
Flavie Perrier Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo https://orcid.org/0000-0001-6979-9656
Marit B. Veierød Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo https://orcid.org/0000-0002-2083-2758

DOI:

https://doi.org/10.2340/actadv.v104.26110

Keywords:

incidence study, melanoma, tumour thickness, trends, demographic factors

Abstract

Monitoring melanoma incidence time trends by tumour thickness is essential to understanding the evolution of melanoma occurrence and guiding prevention strategies. To assess long-term incidence trends, tumour thickness was extracted from pathology reports in the Cancer Registry of Norway (1983–2007) and the Norwegian Melanoma Registry (2008–2019), n = 45,635 patients. Across all anatomic sites, T1 (≤ 1 mm) incidence increased most (men annual percentage change [AAPC] = 4.6, 95% confidence interval [95% CI] 4.2–5.0; women AAPC = 3.2, 95% CI 2.8–3.6); the increase was steep until 1989/90, followed by a plateau, and a further steep increase from 2004/05. Increased incidence was also observed for T2 (>1.0–2.0) melanoma (men AAPC = 2.8, 95% CI 2.4–3.2; women AAPC = 1.5, 95% CI 1.1–1.9), and T3 (>2.0–4.0) in men (AAPC = 1.4, 95% CI 0.9–1.9). T4 (>4.0) melanoma followed a similar overall pattern (men AAPC = 1.3, 95% CI 0.9–1.7, head/neck, upper limbs, and trunk; women AAPC = 0.9, 95% CI 0.4–1.4, upper limbs and trunk). Men had the highest T3 and T4 incidence and the sex difference increased with age. Regarding birth cohorts, age-specific incidence increased in all T categories in the oldest age groups, while stabilizing in younger patients born after 1950. Overall, the steep increase in T1 melanoma was not accompanied by a decrease in thick melanoma.

Downloads

Download data is not yet available.

Author Biographies

Raju Rimal, Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

Postdoctoral Fellow

Affiliations

Oslo Centre for Biostatistics and Epidemiology (OCBE)
EpiStat: Epidemiological Studies of Lifestyle and Chronic Diseases

Trude E. Robsahm, Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway

Researcher and Head of section

Department: Research Department Section: Section for epidemiology and prevention

Adele C. Green, Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Cancer Research UK Manchester Institute, University of Manchester, Manchester, United Kingdom

Senior Scientist, Cancer and Populations Studies, QIMR Berghofer

Other Affiliation:

Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia

Cancer Research UK Manchester Institute, University of Manchester, Manchester, United Kingdom

Bjørn Møller, Department of Registration, Cancer Registry of Norway, Oslo, Norway

Head of Department of Registration

Marit B. Veierød, Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo

Affiliations
Department of Biostatistics/Oslo Centre for Biostatistics and Epidemiology
Department of Nutrition

References

ld M, de Vries E, Whiteman DC, Jemal A, Bray F, Parkin DM, et al. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int J Cancer 2018; 143: 1305-1314.

https://doi.org/10.1002/ijc.31527 DOI: https://doi.org/10.1002/ijc.31527

Welch HG, Mazer BL, Adamson AS. The rapid rise in cutaneous melanoma diagnoses. N Engl J Med 2021; 384: 72-79.

https://doi.org/10.1056/NEJMsb2019760 DOI: https://doi.org/10.1056/NEJMsb2019760

Sacchetto L, Zanetti R, Comber H, Bouchardy C, Brewster DH, Broganelli P, et al. Trends in incidence of thick, thin and in situ melanoma in Europe. Eur J Cancer 2018; 92: 108-118.

https://doi.org/10.1016/j.ejca.2017.12.024 DOI: https://doi.org/10.1016/j.ejca.2017.12.024

Bianconi F, Crocetti E, Grisci C, Primieri C, Stracci F. What has changed in the epidemiology of skin melanoma in central Italy during the past 20 years? Melanoma Res 2020; 30: 396-401.

https://doi.org/10.1097/CMR.0000000000000551 DOI: https://doi.org/10.1097/CMR.0000000000000551

Leeneman B, Schreuder K, Uyl-de Groot CA, Van Akkooi ACJ, Haanen JBAG, Wakkee M, et al. Stage-specific trends in incidence and survival of cutaneous melanoma in the Netherlands (2003-2018): a nationwide population-based study. Eur J Cancer 2021; 154: 111-119.

https://doi.org/10.1016/j.ejca.2021.06.007 DOI: https://doi.org/10.1016/j.ejca.2021.06.007

Shaikh WR, Dusza SW, Weinstock MA, Oliveria SA, Geller AC, Halpern AC. Melanoma thickness and survival trends in the United States, 1989-2009. J Natl Cancer Inst 2016; 108: djv294-djv294.

https://doi.org/10.1093/jnci/djv294 DOI: https://doi.org/10.1093/jnci/djv294

Schwartz MR, Luo L, Berwick M. Sex differences in melanoma. Curr Epidemiol Rep 2019; 6: 112-118.

https://doi.org/10.1007/s40471-019-00192-7 DOI: https://doi.org/10.1007/s40471-019-00192-7

Robsahm TE, Helsing P, Nilssen Y, Vos L, Rizvi SMH, Akslen LA, et al. High mortality due to cutaneous melanoma in Norway: a study of prognostic factors in a nationwide cancer registry. Clin Epidemiol 2018; 10: 537-548.

https://doi.org/10.2147/CLEP.S151246 DOI: https://doi.org/10.2147/CLEP.S151246

Eriksson H, Nielsen K, Vassilaki I, Lapins J, Mikiver R, Lyth J, et al. Trend shifts in age-specific incidence for in situ and invasive cutaneous melanoma in Sweden. Cancers (Basel) 2021; 13: 2838.

https://doi.org/10.3390/cancers13112838 DOI: https://doi.org/10.3390/cancers13112838

Stefansson H, Tryggvadottir L, Olafsdottir EJ, Mooney E, Olafsson JH, Sigurgeirsson B, et al. Cutaneous melanoma in Iceland: changing Breslow's tumour thickness. J Eur Acad Dermatol Venereol 2015; 29: 346-352.

https://doi.org/10.1111/jdv.12552 DOI: https://doi.org/10.1111/jdv.12552

Aitken JF, Youlden DR, Baade PD, Soyer HP, Green AC, Smithers BM. Generational shift in melanoma incidence and mortality in Queensland, Australia, 1995-2014. Int J Cancer 2018; 142: 1528-1535.

https://doi.org/10.1002/ijc.31141 DOI: https://doi.org/10.1002/ijc.31141

Robsahm TE, Bergva G, Hestvik UE, Møller B. Sex differences in rising trends of cutaneous malignant melanoma in Norway, 1954-2008. Melanoma Res 2013; 23: 70-78.

https://doi.org/10.1097/CMR.0b013e32835c7e48 DOI: https://doi.org/10.1097/CMR.0b013e32835c7e48

Gershenwald JE, Scolyer RA, Hess KR, Sondak VK, Long GV, Ross MI, et al. Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin 2017; 67: 472-492.

https://doi.org/10.3322/caac.21409 DOI: https://doi.org/10.3322/caac.21409

Walters S, Maringe C, Butler J, Brierley JD, Rachet B, Coleman MP. Comparability of stage data in cancer registries in six countries: lessons from the International Cancer Benchmarking Partnership. Int J Cancer 2013; 132: 676-685.

https://doi.org/10.1002/ijc.27651 DOI: https://doi.org/10.1002/ijc.27651

Andersen PK, Borgan O, Gill RD, Keiding N. Statistical models based on counting processes. Berlin/Heidelberg: Springer Science & Business Media; 2012.

Engholm G, Ferlay J, Christensen N, Bray F, Gjerstorff ML, Klint Å, et al. NORDCAN - a Nordic tool for cancer information, planning, quality control and research. Acta Oncol 2010; 49: 725-736.

https://doi.org/10.3109/02841861003782017 DOI: https://doi.org/10.3109/02841861003782017

Rubin DB. Multiple imputation for nonresponse in surveys. Chichester/New York: Wiley; 2004.

Wagner AK, Soumerai SB, Zhang F, Ross-Degnan D. Segmented regression analysis of interrupted time series studies in medication use research. J Clin Phar Ther 2002; 27: 299-309.

https://doi.org/10.1046/j.1365-2710.2002.00430.x DOI: https://doi.org/10.1046/j.1365-2710.2002.00430.x

Muggeo VMR. Segmented: an R package to fit regression models with broken-line relationships. R News 2008; 8: 20-25.

Muggeo VMR. Estimating regression models with unknown break-points. Stat Med 2003; 22: 3055-3071.

https://doi.org/10.1002/sim.1545 DOI: https://doi.org/10.1002/sim.1545

Hollestein LM, van den Akker SAW, Nijsten T, Karim-Kos HE, Coebergh JW, de Vries E. Trends of cutaneous melanoma in The Netherlands: increasing incidence rates among all Breslow thickness categories and rising mortality rates since 1989. Ann Oncol 2012; 23: 524-530.

https://doi.org/10.1093/annonc/mdr128 DOI: https://doi.org/10.1093/annonc/mdr128

Van Der Leest RJT, Zoutendijk J, Nijsten T, Mooi WJ, Van Der Rhee JI, De Vries E, et al. Increasing time trends of thin melanomas in The Netherlands: what are the explanations of recent accelerations? Eur J Cancer 2015; 51: 2833-2841.

https://doi.org/10.1016/j.ejca.2015.09.008 DOI: https://doi.org/10.1016/j.ejca.2015.09.008

Helvind NM, Hölmich LR, Smith S, Glud M, Andersen KK, Dalton SO, et al. Incidence of in situ and invasive melanoma in Denmark from 1985 through 2012: a national database study of 24 059 melanoma cases. JAMA Dermatol 2015; 151: 1087-1095.

https://doi.org/10.1001/jamadermatol.2015.1481 DOI: https://doi.org/10.1001/jamadermatol.2015.1481

Erdmann F, Lortet-Tieulent J, Schüz J, Zeeb H, Greinert R, Breitbart EW, et al. International trends in the incidence of malignant melanoma 1953-2008: are recent generations at higher or lower risk? Int J Cancer 2013; 132: 385-400.

https://doi.org/10.1002/ijc.27616 DOI: https://doi.org/10.1002/ijc.27616

Baade P, Meng X, Youlden D, Aitken J, Youl P. Time trends and latitudinal differences in melanoma thickness distribution in Australia, 1990-2006. Int J Cancer 2012; 130: 170-178.

https://doi.org/10.1002/ijc.25996 DOI: https://doi.org/10.1002/ijc.25996

Chen ML, de Vere Hunt IJ, John EM, Weinstock MA, Swetter SM, Linos E. Differences in thickness-specific incidence and factors associated with cutaneous melanoma in the US from 2010 to 2018. JAMA Oncol 2022; 8: 755-759.

https://doi.org/10.1001/jamaoncol.2022.0134 DOI: https://doi.org/10.1001/jamaoncol.2022.0134

Iannacone MR, Green AC. Towards skin cancer prevention and early detection: evolution of skin cancer awareness campaigns in Australia. Melanoma Manag 2014; 1: 75-84.

https://doi.org/10.2217/mmt.14.6 DOI: https://doi.org/10.2217/mmt.14.6

Lergenmuller S, Rueegg CS, Perrier F, Robsahm TE, Green AC, Lund E, et al. Lifetime sunburn trajectories and associated risks of cutaneous melanoma and squamous cell carcinoma among a cohort of Norwegian women. JAMA Dermatol 2022; 158: 1367-1377.

https://doi.org/10.1001/jamadermatol.2022.4053 DOI: https://doi.org/10.1001/jamadermatol.2022.4053

Kreftforeningen i samarbeid med Direktoratet for strålevern og atomsikkerhet (DSA). Solvaneundersøkelse i den norske befolkningen 2022; 2022.

Kerr KF, Elder DE, Piepkorn MW, Knezevich SR, Eguchi MM, Shucard HL, et al. Pathologist characteristics associated with rendering higher-grade diagnoses for melanocytic lesions. JAMA Dermatol 2023; 159: 1315-1322.

https://doi.org/10.1001/jamadermatol.2023.4334 DOI: https://doi.org/10.1001/jamadermatol.2023.4334

Gjersvik P, Veierød MB, Thompson A, Grzyb K, Liland KH, Vazov N, et al. Histopathologic reassessment of melanoma and other melanocytic skin lesions excised in 2009 and 2018-2019. Tidsskr Nor Laegeforen 2022; 142(15).

https://doi.org/10.4045/tidsskr.22.0204 DOI: https://doi.org/10.4045/tidsskr.22.0204

Corneli P, Zalaudek I, Magaton Rizzi G, di Meo N. Improving the early diagnosis of early nodular melanoma: can we do better? Expert Rev Anticancer Ther 2018; 18: 1007-1012.

https://doi.org/10.1080/14737140.2018.1507822 DOI: https://doi.org/10.1080/14737140.2018.1507822

Geller AC, Elwood M, Swetter SM, Brooks DR, Aitken J, Youl PH, et al. Factors related to the presentation of thin and thick nodular melanoma from a population-based cancer registry in Queensland Australia. Cancer 2009; 115: 1318-1327.

https://doi.org/10.1002/cncr.24162 DOI: https://doi.org/10.1002/cncr.24162

Liu W, Dowling JP, Murray WK, McArthur GA, Thompson JF, Wolfe R, et al. Rate of growth in melanomas: characteristics and associations of rapidly growing melanomas. Arch Dermatol 2006; 142: 1551-1558.

https://doi.org/10.1001/archderm.142.12.1551 DOI: https://doi.org/10.1001/archderm.142.12.1551

Bjørch MF, Gram EG, Brodersen JB. Overdiagnosis in malignant melanoma: a scoping review. BMJ Evid Based Med 2024; 29: 17-28.

https://doi.org/10.1136/bmjebm-2023-112341 DOI: https://doi.org/10.1136/bmjebm-2023-112341

Whiteman DC, Olsen CM, MacGregor S, Law MH, Thompson B, Dusingize JC, et al. The effect of screening on melanoma incidence and biopsy rates. Br J Dermatol 2022; 187: 515-522.

https://doi.org/10.1111/bjd.21649 DOI: https://doi.org/10.1111/bjd.21649

Whiteman DC, Baade PD, Olsen CM. More people die from thin melanomas (≤1 mm) than from thick melanomas (>4 mm) in Queensland, Australia. J Invest Dermatol 2015; 135: 1190-1193.

https://doi.org/10.1038/jid.2014.452 DOI: https://doi.org/10.1038/jid.2014.452

Cancer Registry of Norway. Cancer in Norway 2021: cancer incidence, mortality, survival and prevalence in Norway. Oslo: Cancer Registry of Norway; 2022.

Shaikh WR, Weinstock MA, Halpern AC, Oliveria SA, Geller AC, Dusza SW. The characterization and potential impact of melanoma cases with unknown thickness in the United States' Surveillance, Epidemiology, and End Results Program, 1989-2008. Cancer Epidemiol 2013; 37: 64-70.

https://doi.org/10.1016/j.canep.2012.08.010 DOI: https://doi.org/10.1016/j.canep.2012.08.010

Trends in Invasive Melanoma Thickness in Norway, 1983–2019

Authors

DOI:

Keywords:

Abstract

Downloads

Author Biographies

Raju Rimal, Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

Trude E. Robsahm, Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway

Adele C. Green, Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Cancer Research UK Manchester Institute, University of Manchester, Manchester, United Kingdom

Bjørn Møller, Department of Registration, Cancer Registry of Norway, Oslo, Norway

Marit B. Veierød, Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo

References

Downloads

Additional Files

Published

How to Cite

Issue

Section

Categories

License

Funding data

about

submit

Social media

Browse

Information

Trends in Invasive Melanoma Thickness in Norway, 1983–2019

Authors

DOI:

Keywords:

Abstract

Downloads

Author Biographies

Raju Rimal, Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

Trude E. Robsahm, Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway

Adele C. Green, Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Cancer Research UK Manchester Institute, University of Manchester, Manchester, United Kingdom

Bjørn Møller, Department of Registration, Cancer Registry of Norway, Oslo, Norway

Marit B. Veierød, Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo

References

Downloads

Additional Files

Published

How to Cite

Issue

Section

Categories

License

Funding data

about

submit

Newsletter

Keep up to date with the latest research in ActaDV.

Social media

Browse

Information