Incidence, Mortality, and Spatiotemporal Distribution of Cutaneous Malignant Melanoma Cases Across Canada

J Cutan Med Surg. 2019 Jul/Aug;23(4):394-412. doi: 10.1177/1203475419852048. Epub 2019 May 27.

Abstract

Background: We recently reported a steady increase in the incidence and mortality of cutaneous malignant melanoma (CMM) in Canada during 1992-2010.

Objectives: The objective of this article is to examine the distribution of Canadian CMM patients at the level of provinces, cities, and forward sortation area (FSA) postal codes.

Methods: Using 3 Canadian population-based registries, we conducted an in-depth examination of the incidence and mortality trends for 72 565 Canadian CMM patients over the period 1992-2010.

Results: We found that among 20- to 39-year-olds, the incidence of CMM in women (7.17 per 100 000 individuals) was significantly higher than in men (4.60 per 100 000 individuals per year). Women age 80 years and older had an incidence of CMM (58.46 cases per 100 000 women per year) more than 4 times greater than the national average (12.29 cases per 100 000 population per year) and a corresponding high mortality rate (20.18 deaths per 100 000 women per year), when compared with the Canadian melanoma mortality of 2.4 deaths per 100 000 per year. In other age groups men had higher incidence and corresponding melanoma mortality rates. We also studied CMM incidence by province, city, and FSA postal codes and identified several high-incidence communities that were located near the coast/waterfronts. In addition, plotting latitude measures for cities and FSAs vs CMM incidence rate confirmed the inverse relationship between geographical latitude and incidence of melanoma in Canada (slope = -0.22 ± 0.05).

Conclusions: This research may help develop sex-, age- and geographic region-specific recommendations to decrease the future burden of CMM in Canada.

Keywords: CMM; cutaneous malignant melanoma; epidemiology in Canada; incidence in Canada; mortality in Canada; patient clusters; risk factors; sun-exposure practices.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Canada / epidemiology
  • Child
  • Child, Preschool
  • Female
  • Geographic Mapping
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Melanoma / epidemiology*
  • Melanoma / mortality
  • Middle Aged
  • Sex Factors
  • Skin Neoplasms / epidemiology*
  • Skin Neoplasms / mortality
  • Spatio-Temporal Analysis
  • Young Adult