Trends in incidence, mortality and survival for cutaneous malignant melanoma from 1970 to 2013 in Canton Geneva, Switzerland

Objectives: The aim of this study is to describe the trends in the epidemiology of cutaneous malignant melanoma (MM) in the Canton of Geneva, Switzerland, taking into account multiple variables, namely age, sex, socioeconomic status, origin of diagnosis, sector of care, localization, subtype, and Breslow depth. Methods: We retrieved from the Geneva Cancer Registry data on the 3,557 patients recorded with a diagnosis of MM in the period spanning 1970 to 2013. We calculated age-adjusted incidence and mortality rates and undertook a Joinpoint regression analysis to compute the annual percentage change (APC) of the respective trends. We also computed melanoma-specific survival using Kaplan-Meier estimation, and we assessed the determinants of survival with a univariate model as well as a multi-adjusted Cox regression analysis. Results: Incidence rates are quite similar between males and females. Incidence rates in women increased until the 2002-2005 period (APC 4.78), after which we note a plateau, while rates in men continue to increase until the end of the study period (APC +3.80). Incidence rates for individual sex-age-groups all increase except for males under 30, with greater increases seen among older age groups. Incidence of SSM has increased far more than other subtypes. Mortality rates are approximately double for males compared to females. Overall mortality rates have remained stable, though there is an increase in males 70 and above until 1994-1997 (APC +4.85), and a continuous decrease in males under 50 (APC -2.71). Ten-year specific survival for males and females respectively was 83% and 90% (p logrank test Conclusions: These results are consistent with those observed in other European regions. Most of these results can be explained by the increased public awareness of melanoma which lead to early diagnoses and more effective preventive measures. This study also identified sub-groups of the population that could benefit of more targeted prevention and screening interventions