Melanoma in England: incidence is up, mortality is down
In recent decades, the epidemiology of cutaneous melanoma has undergone profound changes in many populations around the world, with steep rises in incidence set against recent declines in mortality. In this issue of the BJD, Karponis and colleagues present the findings of an analysis of melanoma trends in England during the past 20 years.1 The data underpinning these analyses are population-based, complete and of long duration, allowing the analysts to characterize and quantify the changes in rates over time. This report contains much important information, but there are three principal observations.
The first key finding is the very rapid increase in the incidence of melanomas in situ, and while the authors note a recent deceleration in the rate of increase from almost 8% per year in 2001–14 to around 2% per year in 2015–19, it remains the case that even this rate of increase is remarkable. (The lower incidence rates observed for 2020 are impossible to interpret in light of the pandemic.) Similar rapid increases in the incidence of melanomas in situ have been reported elsewhere, for which overdiagnosis (‘looking more and finding more’) and diagnostic drift (‘shifting the goalposts’) have been nominated as likely explanations.2,3 Descriptive data such as these cannot fully elucidate the causes, but they provide a powerful motivation to understand the underlying phenomena.
Source:
David C Whiteman, Melanoma in England: incidence is up, mortality is down, British Journal of Dermatology, 2025;, ljaf175, https://doi.org/10.1093/bjd/ljaf175