Mid-term trends and recent birth-cohort-dependent changes in incidence rates of cutaneous malignant melanoma in Italy

Lauro Bucchi, Silvia Mancini, Emanuele Crocetti, Luigino Dal Maso, Flavia Baldacchini, Rosa Vattiato, Orietta Giuliani, Alessandra Ravaioli, Adele Caldarella, Giuliano Carrozzi, Stefano Ferretti, Rosa Angela Filiberti, Mario Fusco, Luciana Gatti, Alessio Gili, Michele Magoni, Lucia Mangone, Guido Mazzoleni, Maria Michiara, Chiara PanatoSilvano Piffer, Daniela Piras, Stefano Rosso, Massimo Rugge, Umberto Scala, Giovanna Tagliabue, Rosario Tumino, Ignazio Stanganelli, Fabio Falcini

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)835-844
Number of pages10
JournalInt. J. Cancer
Issue number4
Publication statusPublished - Feb 15 2021


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