Predicting Melanoma Impact on the Swedish Healthcare System from the Adult Population Using Machine Learning on Registry Data

Authors

  • Martin Gillstedt Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden https://orcid.org/0000-0001-5033-5421
  • Lena Stempfle Department of Computer Science and Engineering, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden https://orcid.org/0000-0002-6580-3942
  • John Paoli Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden https://orcid.org/0000-0003-1326-8535
  • Fredrik D. Johansson Department of Computer Science and Engineering, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden https://orcid.org/0000-0002-4323-3715
  • Sam Polesie Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden; Center for Digital Health, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden https://orcid.org/0000-0002-5398-6200

DOI:

https://doi.org/10.2340/actadv.v106.44610

Keywords:

melanoma, machine learning, dermatology, healthcare register, prediction

Abstract

Melanoma incidence has increased in Western countries over the past 50 years, leading to significant healthcare costs. In Sweden, comprehensive healthcare registries enable large-scale prediction studies using machine learning. Several machine learning models were evaluated to predict melanoma diagnoses using Swedish registry data, assessing the added value of diagnostic and medication data beyond demographics. The study included all adults in Sweden with continuous residency for 9.5 years (n =6,036,186). The outcome was a melanoma diagnosis, including melanoma in situ, recorded within 5 years after the index date (31 December 2014). Predictors included age, sex, income, education, marital status, region of birth, diagnoses, and dispensed drugs. Models tested were logistic regression, gradient boosting, random forests, and a neural network. A total of 38,582 individuals (0.64%) developed melanoma. The gradient boosting model using all predictors performed best, with an area under the receiving operating characteristics curve (AUC) of 0.735 (95% confidence interval [CI], 0.725–0.746). When diagnosis and medication data were excluded, AUC dropped to 0.681 (95% CI: 0.670–0.691). The findings highlight that including healthcare codes improves predictive performance, and demonstrate the utility of Swedish registries for computational phenotyping. This approach may support early detection of melanoma and targeted follow-up.

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References

Claeson M, Gillstedt M, Whiteman DC, Paoli J. Lethal melanomas: a population-based registry study in Western Sweden from 1990 to 2014. Acta Derm Venereol 2017; 97: 1206–1211. DOI: https://doi.org/10.2340/00015555-2758

Godar DE. Worldwide increasing incidences of cutaneous malignant melanoma. J Skin Cancer 2011; 2011: 858425. DOI: https://doi.org/10.1155/2011/858425

Guy GP Jr, Thomas CC, Thompson T, Watson M, Massetti GM, Richardson LC, et al. Vital signs: melanoma incidence and mortality trends and projections – United States, 1982–2030. MMWR Morb Mortal Wkly Rep 2015; 64: 591–596.

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin2022; 72: 7–33. DOI: https://doi.org/10.3322/caac.21708

Whiteman DC, Green AC, Olsen CM. The growing burden of invasive melanoma: projections of incidence rates and numbers of new cases in six susceptible populations through 2031. J Invest Dermatol 2016; 136: 1161–1171. DOI: https://doi.org/10.1016/j.jid.2016.01.035

Pukkala E, Engholm G, Højsgaard Schmidt LK, Storm H, Khan S, Lambe M, et al. Nordic Cancer Registries: an overview of their procedures and data comparability. Acta Oncol 2018; 57: 440–455. DOI: https://doi.org/10.1080/0284186X.2017.1407039

Laugesen K, Ludvigsson JF, Schmidt M, Gissler M, Valdimarsdottir UA, Lunde A, et al. Nordic health registry-based research: a review of health care systems and key registries. Clin Epidemiol 2021; 13: 533–554. DOI: https://doi.org/10.2147/CLEP.S314959

Seedahmed MI, Mogilnicka I, Zeng S, Luo G, Whooley MA, McCulloch CE, et al. Performance of a computational phenotyping algorithm for sarcoidosis using diagnostic codes in electronic medical records: case validation study from 2 veterans Affairs Medical Centers. JMIR Form Res 2022; 6: e31615. DOI: https://doi.org/10.2196/31615

Katalinic A, Eisemann N, Waldmann A. Skin cancer screening in Germany: documenting melanoma incidence and mortality from 2008 to 2013. Dtsch Arztebl Int 2015; 112: 629–634. DOI: https://doi.org/10.3238/arztebl.2015.0629

Matsumoto M, Wack S, Weinstock MA, Geller A, Wang H, Solano FX, et al. Five-year outcomes of a melanoma screening initiative in a large health care system. JAMA Dermatol 2022; 158: 504–512. DOI: https://doi.org/10.1001/jamadermatol.2022.0253

Breiman L. Random forests. Machine Learning 2001; 45: 5–32. DOI: https://doi.org/10.1023/A:1010933404324

Mason L, Baxter J, Bartlett P, Frean M. Boosting algorithms as gradient descent. Advances in neural information processing systems, 1999; 12. https://papers.nips.cc/paper_files/paper/1999/file/96a93ba89a5b5c6c226e49b88973f46e-Paper.pdf

DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988; 44: 837–845. DOI: https://doi.org/10.2307/2531595

Benjamini Y, Yekutieli D. The control of the false discovery rate in multiple testing under dependency. Ann Statist 2001; 29: 1165–1188. DOI: https://doi.org/10.1214/aos/1013699998

Chauhan A, Walton M, Manias E, Walpola RL, Seale H, Latanik M, et al. The safety of health care for ethnic minority patients: a systematic review. Int J Equity Health 2020; 19: 118. DOI: https://doi.org/10.1186/s12939-020-01223-2

Hadziabdic E, Heikkila K, Albin B, Hjelm K. Problems and consequences in the use of professional interpreters: qualitative analysis of incidents from primary healthcare. Nurs Inq 2011; 18: 253–261. DOI: https://doi.org/10.1111/j.1440-1800.2011.00542.x

Ezenwa E, Buster K. Health disparities and skin cancer in people of color. Pract Dermatol 2019: 38–42.

Wang HH, Wang YH, Liang CW, Li YC. Assessment of deep learning using nonimaging information and sequential medical records to develop a prediction model for nonmelanoma skin cancer. JAMA Dermatol 2019; 155: 1277–1283. DOI: https://doi.org/10.1001/jamadermatol.2019.2335

Gillstedt M, Polesie S. Ability to predict melanoma within 5 years using registry data and a convolutional neural network: a proof of concept study. Acta Derm Venereol 2022; 102: adv00750. DOI: https://doi.org/10.2340/actadv.v102.2028

Philonenko P, Kokh V, Blinov P. Combining survival analysis and machine learning for mass cancer risk prediction using EHR data. arXiv preprint arXiv:230915039, 2023. DOI: https://doi.org/10.21203/rs.3.rs-3611680/v1

Li L, Pu C, Jin N, Zhu L, Hu Y, Cascone P, et al. Prediction of 5-year overall survival of tongue cancer based machine learning. BMC Oral Health 2023; 23: 567. DOI: https://doi.org/10.1186/s12903-023-03255-w

Baltzer N, Sundstrom K, Nygard JF, Dillner J, Komorowski J. Risk stratification in cervical cancer screening by complete screening history: applying bioinformatics to a general screening population. Int J Cancer 2017; 141: 200–209. DOI: https://doi.org/10.1002/ijc.30725

Cui Y, Shi X, Wang S, Qin Y, Wang B, Che X, et al. Machine learning approaches for prediction of early death among lung cancer patients with bone metastases using routine clinical characteristics: an analysis of 19,887 patients. Front Public Health 2022; 10: 1019168. DOI: https://doi.org/10.3389/fpubh.2022.1019168

Tang J, Wang X, Wan H, Lin C, Shao Z, Chang Y, et al. Joint modeling strategy for using electronic medical records data to build machine learning models: an example of intracerebral hemorrhage. BMC Med Inform Decis Mak 2022; 22: 278. DOI: https://doi.org/10.1186/s12911-022-02018-x

Liljendahl MS, Ibler K, Vestergaard C, Skov L, Jain P,Rudolfsen JH, et al. Identifying mild-to-moderate atopic dermatitis using a generic machine learning approach: a Danish National Health Register Study. Acta Derm Venereol 2025; 105: adv42250. DOI: https://doi.org/10.2340/actadv.v105.42250

Dullerud N, Roth K, Hamidieh K, Papernot N, Ghassemi M. Is fairness only metric deep? evaluating and addressing subgroup gaps in deep metric learning. arXiv preprint arXiv:220312748, 2022.

Published

2026-04-08

How to Cite

Gillstedt, M., Stempfle, L., Paoli, J., Johansson, F. D., & Polesie, S. (2026). Predicting Melanoma Impact on the Swedish Healthcare System from the Adult Population Using Machine Learning on Registry Data. Acta Dermato-Venereologica, 106, adv44610. https://doi.org/10.2340/actadv.v106.44610