Elsevier

Mayo Clinic Proceedings

Volume 65, Issue 10, October 1990, Pages 1293-1302
Mayo Clinic Proceedings

Cutaneous Malignant Melanoma in Rochester, Minnesota: Trends in Incidence and Survivorship, 1950 Through 1985

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In Rochester, Minnesota, 107 incidence cases of cutaneous malignant melanoma (in 46 male and 61 female patients) were diagnosed during the years 1950 through 1985. Overall crude incidence rates were 6.0 and 6.6 per 100,000 males and females, respectively. Evaluation of trends in 9-year periods showed that the rates increased from 3.2 to 8.9 for males (P = 0.015) and from 4.4 to 11.7 for females (P<0.001). Age-specific rates suggested that the highest incidence occurs in the age-groups 50 to 59 years and 70 years or older for males and 40 to 49 years and 70 years or older for females. Lesions were most common in the head and neck area among males (P = 0.044) and on the lower extremities among females (P = 0.018). The most frequent histologic type was superficial spreading melanoma (61%). Five-year survival was diminished overall for patients with cutaneous malignant melanoma—0.72 in comparison with 0.88 expected for the general population. Statistically significant risk factors for survival were depth of invasion of the lesion (Clark level), thickness of the lesion, histologic type, and age of the patient.

Section snippets

METHODS

Rochester, with a population of 62,000, is an urban community in southeastern Minnesota. Health care for the community is provided almost exclusively by the medical staff of the Mayo Clinic, its affiliated hospitals, and a smaller medical practice known as the Olmsted Medical Group with its affiliated Olmsted Community Hospital. During the past several decades, a records-linkage system and a comprehensive diagnostic index have been developed for this population. Patients with cutaneous

RESULTS

During the 36-year period of the study, 107 cases of cutaneous malignant melanoma (in 46 male and 61 female patients) satisfied the diagnostic and residency criteria (Table 1). Among these were 7 cases of cutaneous malignant melanoma in situ and 100 cases of invasive cutaneous malignant melanoma with Clark level 2 or higher. Overall crude incidence rates for 1950 through 1985 were 6.0 and 6.6 per 100,000 males and females, respectively. Corresponding adjusted rates were 7.3 and 6.4,

DISCUSSION

In our determination of the incidence rates of cutaneous malignant melanoma for the population of Rochester, Minnesota, during the 36-year period 1950 through 1985, our trend analysis focused on four periods of 9 years each. The rates were relatively stable during the first two periods (1950 through 1958 and 1959 through 1967) and then rapidly increased during the most recent two periods (1968 through 1976 and 1977 through 1985). The pattern of the incidence was similar in both sexes. This

CONCLUSION

Our study in a defined population has confirmed an increase in incidence of cutaneous malignant melanoma for both sexes, most notably in the past decade. The most frequent sites for lesions in this series were the head and neck for males and the lower extremities for females. Although sample sizes were relatively small for evaluating multivariate associations of risk factors with survival, the best predictors of survival were histologic findings (including histologic type, Clark level, and

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  • Cited by (0)

    This study was supported in part by Grant AR 30582 from the National Institutes of Health, Public Health Service.

    *

    Current address: Strong Memorial Hospital, Rochester, New York.

    Mayo Clinic Scottsdale, Scottsdale, Arizona.

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