Recent trends in cutaneous melanoma incidence and death rates in the United States, 1992-2006

Background: Increasing cutaneous melanoma incidence rates in the United States have been attributed to heightened detection of thin (<= 1-mm) lesions. Objective: We sought to describe melanoma incidence and mortality trends in the 12 cancer registries covered by the Surveillance, Epidemiology, and End Results program and to estimate the contribution of thin lesions to melanoma mortality. Methods: We used joinpoint analysis of Surveillance, Epidemiology, and End Results incidence and mortality data from 1992 to 2006. Results: During 1992 through 2006, melanoma incidence rates among non-Hispanic whites increased for all ages and tumor thicknesses. Death rates increased for older (>65 years) but not younger persons. Between 1998 to 1999 and 2004 to 2005, melanoma death rates associated with thin lesions increased and accounted for about 30% of the total melanoma deaths. Limitations: Availability of long-term incidence data for 14% of the US population was a limitation. Conclusions: The continued increases in melanoma death rates for older persons and for thin lesions suggest that the increases may partly reflect increased ultraviolet radiation exposure. The substantial contribution of thin lesions to melanoma mortality underscores the importance of standard wide excision techniques and the need for molecular characterization of the lesions for aggressive forms. (J Am Acad Dermatol 2011;65:S17-25.)