TY - JOUR
T1 - Mid-term trends and recent birth-cohort-dependent changes in incidence rates of cutaneous malignant melanoma in Italy
AU - Bucchi, Lauro
AU - Mancini, Silvia
AU - Crocetti, Emanuele
AU - Dal Maso, Luigino
AU - Baldacchini, Flavia
AU - Vattiato, Rosa
AU - Giuliani, Orietta
AU - Ravaioli, Alessandra
AU - Caldarella, Adele
AU - Carrozzi, Giuliano
AU - Ferretti, Stefano
AU - Filiberti, Rosa Angela
AU - Fusco, Mario
AU - Gatti, Luciana
AU - Gili, Alessio
AU - Magoni, Michele
AU - Mangone, Lucia
AU - Mazzoleni, Guido
AU - Michiara, Maria
AU - Panato, Chiara
AU - Piffer, Silvano
AU - Piras, Daniela
AU - Rosso, Stefano
AU - Rugge, Massimo
AU - Scala, Umberto
AU - Tagliabue, Giovanna
AU - Tumino, Rosario
AU - Stanganelli, Ignazio
AU - Falcini, Fabio
PY - 2020
Y1 - 2020
N2 - In Oceania, North America and north-western Europe, after decades of increase, cutaneous malignant melanoma (CMM) rates began to stabilise or decline before 2000. Anecdotal evidence suggests that the reversal of the incidence trend is extending to southern Europe. To obtain a formal confirmation, this nationwide study from Italy investigated the incidence trends by birth cohort. Twenty-one local cancer registries covering a population of 15 814 455 provided incidence data for primary CMM registered between 1994 and 2013. Trends in age-standardised rates were analysed using joinpoint regression models and age-period-cohort models. Age-standardised incidence showed a consistent increase throughout the period (estimated annual percent change, 3.6 [95% confidence interval, 3.2-4.0] among men and 2.5 [2.0-3.1] among women). This pattern was confirmed by a sensitivity analysis with removal of low-risk populations of southern Italy. The rates, however, showed a stabilisation or a decrease in men and women aged below 35. Using the cohort of 1949—the median cohort with respect to the number of cases for both genders—as a reference, the incidence rate ratio increased for successive cohorts born until 1973 (women) and 1975 (men), and subsequently tended to decline. For the most recent cohorts in both genders, the risk of disease returned to the level of the cohort of 1949. The changes observed in the latest generations can be interpreted as the earliest manifestations of a birth-cohort-dependent incidence decrease. Our study adds to previous data indicating that the reversal of the long-term upward incidence trend of CMM is extending to southern Europe.
AB - In Oceania, North America and north-western Europe, after decades of increase, cutaneous malignant melanoma (CMM) rates began to stabilise or decline before 2000. Anecdotal evidence suggests that the reversal of the incidence trend is extending to southern Europe. To obtain a formal confirmation, this nationwide study from Italy investigated the incidence trends by birth cohort. Twenty-one local cancer registries covering a population of 15 814 455 provided incidence data for primary CMM registered between 1994 and 2013. Trends in age-standardised rates were analysed using joinpoint regression models and age-period-cohort models. Age-standardised incidence showed a consistent increase throughout the period (estimated annual percent change, 3.6 [95% confidence interval, 3.2-4.0] among men and 2.5 [2.0-3.1] among women). This pattern was confirmed by a sensitivity analysis with removal of low-risk populations of southern Italy. The rates, however, showed a stabilisation or a decrease in men and women aged below 35. Using the cohort of 1949—the median cohort with respect to the number of cases for both genders—as a reference, the incidence rate ratio increased for successive cohorts born until 1973 (women) and 1975 (men), and subsequently tended to decline. For the most recent cohorts in both genders, the risk of disease returned to the level of the cohort of 1949. The changes observed in the latest generations can be interpreted as the earliest manifestations of a birth-cohort-dependent incidence decrease. Our study adds to previous data indicating that the reversal of the long-term upward incidence trend of CMM is extending to southern Europe.
KW - age-period-cohort modelling
KW - birth cohort
KW - cutaneous malignant melanoma
KW - incidence
KW - time trend
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U2 - 10.1002/ijc.33259
DO - 10.1002/ijc.33259
M3 - Article
AN - SCOPUS:85089986473
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
ER -