Global Burden of Cutaneous Melanoma in 2020 and Projections to 2040

Abstract

ith more than 1.5 million new cases estimated in 2020, skin cancers are the most commonly diagnosed group of cancers worldwide. Malignant melanomas (hereafter melanoma) account for approximately 1 in 5 of these cancers, with approximately 325 000 cases estimated globally in 2020. Historically a rare disease, melanoma incidence rates have been increasing during the last 50 years in fair-skinned populations of European ancestry. 1,2 Much of this increase is likely due to increased exposure of vulnerable populations to UV radiation, a strong and ubiquitous risk factor for melanoma, emitted naturally by the sun but also from artificial sources. 3,4 According to recent global estimates, more than three-quarters of all newly diagnosed melanoma cases can be attributed to UV radiation. 5 Although the risk of melanoma generally increases with age and incidence is greater among older populations, melanoma is among the most common cancers in young adults. 6 Incidence rates have stabilized or decreased among recent birth cohorts in a few countries, such as Australia and the US. 1,7 The reasons for these decreases in incidence are still debated and are likely associated with a combination of changes in lifestyle and social behavior, ethnic heterogeneity, and population admixture (ie, in which previously diverged or isolated genetic lineages mix). Yet with generational increases in melanoma incidence reported in most other high-risk populations and uniform increases observed in older age groups, the rates and number of melanoma diagnoses are projected to increase in the coming decades, 8,9 emphasizing the urgent need IMPORTANCE Despite many cases being preventable, cutaneous melanoma remains the most serious skin cancer worldwide. Understanding the scale and profile of the disease is vital to concentrate and reinforce global prevention efforts.OBJECTIVE To examine global patterns of cutaneous melanoma in 2020 and to provide projected estimates of cases and deaths by 2040. DESIGN, SETTING, AND PARTICIPANTSThis population-based study used the GLOBOCAN 2020 database for global epidemiological assessment of new cases and deaths due to invasive melanoma.MAIN OUTCOMES AND MEASURES Age-standardized incidence and mortality rates were calculated per 100 000 person-years by country, world region, and 4-tier level of human development. Estimated numbers of cases and deaths were calculated for the year 2040.RESULTS A worldwide total of 325 000 new melanoma cases (174 000 males, 151 000 females) and 57 000 deaths (32 000 males, 25 000 females) was estimated for 2020. Large geographic variations existed across countries and world regions, with the highest incidence rates among males (42 per 100 000 person-years) and females (31 per 100 000 person-years) observed in Australia/New Zealand, followed by Western Europe (19 per 100 000 person-years for males and females), North America (18 per 100 000 person-years for males, 14 per 100 000 person-years for females), and Northern Europe (17 per 100 000 person-years for males, 18 per 100 000 perso...

Dynamic ctDNA mutational complexity in melanoma patients receiving immunotherapy

“…Similar to other studies [76], we found that ctDNA detection in blood samples collected in cell stabilising tubes was possible without significant loss of test sensitivity. As these allow a delay in processing of up to 7 days, they can be applied to support ctDNA testing for geographically-remote patients [32], including some Māori [43, 44] and Pacific People [45] who suffer significant cancer outcome inequities in NZ. In addition, ctDNA analysis undertaken in the intervals between surveillance imaging may provide valuable supplementary information to guide clinical care during health service disruptions, such as those introduced during the COVID-19 pandemic.…”

“…In New Zealand (NZ) where this study is based, people from geographically-remote regions [38] as well as indigenous Māori [39, 40] and Pacific peoples [41], suffer significant inequities in cancer care [42]. In 2020, people in NZ also suffered the highest age-adjusted mortality from metastatic melanoma in the world (5 per 100 000 person-years) [43, 44]. Although the incidence of melanoma in NZ is lower in Māori and Pacific Peoples than in European New Zealanders, Māori and Pacific Peoples on average experience poorer outcomes once diagnosed [45].…”

Clustering trends of melanoma incidence and mortality: A worldwide assessment from 1995 to 2019

“…7,8 Melanoma is uncommon in most African and Asian countries, with most instances having an incidence rate of less than 1 (per 100,000 persons). 9 Although melanoma is more common in white populations, it can occur in other races with low survival rates. 10 In fact, despite recent important advances in prevention, diagnosis and treatment, vast differences in melanoma burden still exist among populations.…”

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“…Melanoma is the cancer of the skin’s pigment cells that caused by abrupt ultraviolet UV radiation from artificial sources or natural sunlight ( 1 , 2 ). The treatment of melanoma is developing rapidly, including complementary disease prevention and detection strategies.…”