Cancer Research Campaign health education programme to promote the early detection of cutaneous malignant melanoma. II. Characteristics and incidence of melanoma

Abstract

The effect on the detection and characteristics of melanoma, resulting from the Cancer Research Campaign's health education programme to promote the early detection of melanoma in the general population, was studied from 1987 to 1989. The seven study areas in England and Scotland yield a target population of 3.6 million. Data were collected from local clinic-based registers, pathology laboratories, and the cancer registries. The average annual incidence rates of melanoma were seven and 12 per 10(5) in males and females, respectively, age-standardized to England and Wales, 1988. These rates are similar to the national figures for Scotland, where there is a national melanoma register, but higher than those reported by the English and Welsh cancer registries. The incidence was significantly higher in females than males (P < 0.001), and increased with age. Fifty-three per cent and 65% of cases in males and females, respectively, were thin (Breslow thickness < or = 1.5 mm), similar to the national figures from Scotland. No significant decrease in the incidence of late-stage tumours was found in either sex as a result of the campaign. Because of difficulties with ascertainment of cases in England, the main evaluation will focus on future trends in mortality rates for melanoma.

Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

“…Increases in thick tumours were seen mainly in the older age groups and similar trends have been observed elsewhere (Murray et al, 2005). The observed increase in thin tumours may suggest a trend towards earlier diagnosis due to increased awareness, but public health campaigns directed towards early detection have been in existence since 1987 (Melia et al, 1995) and so this does not fully explain the increase in female subjects seen after 1999. During the 1980s and the 1990s, as a part of these public health campaigns, a number of pigmented lesion clinics were opened.…”

“…Although time trends in the incidence of and mortality from malignant melanoma (MM) in the UK have been reported by many studies, relatively few studies have looked at these changes in relation to the stage of disease (Melia et al, 1995;Mackie et al, 1997Mackie et al, , 2002Holme et al, 2001). Since the 1990s, the Northern and Yorkshire Cancer Registry and Information Service (NYCRIS) have collected information on Breslow thickness, the most commonly used measure of stage.…”

The relation between mortality from malignant melanoma and early detection in the Cancer Research Campaign Mole Watcher Study

“…Assumptions have to be made about the population exposed to the intervention. In one survey conducted in association with the Mole Watcher study, awareness of the leaflets and posters increased during the intervention (Melia et al, 1995b), but this does not indicate how well people understood the signs of melanoma or how frequently they examined their skin.…”

“…The lack of an effect of the intervention on cumulative mortality occurred despite an apparent rise in the incidence rate of thin melanomas in the intervention areas (Melia et al, 1995b). Others have also shown an apparent rise in the rate for detection of thin melanomas, but no evidence of a reduction in mortality (Dennis, 1999;Lipsker et al, 1999;van der Rhee et al, 1999).…”

“…From 1987 to 1989 the Cancer Research Campaign (CRC) ran a health education programme to promote the early detection of cutaneous malignant melanoma in the general population in 6 district health authorities (DHAs) in England and 1 health board (HB) in Scotland (Melia et al, 1995a(Melia et al, , 1995b. This followed a similar intervention in the west of Scotland (MacKie and Hole, 1992) involving the local media, leaflets and posters.…”