Increasing Incidence of Melanoma in the Elderly: An Epidemiological Study in Olmsted County, Minnesota

Objective To estimate the age- and sex-adjusted incidence of melanoma in adults 61 years or older in Olmsted County, Minnesota, from 1970 through 2009. Patients and Methods Using Rochester Epidemiology Project resources, 397 patients were identified who were 61 years or older and who received a first lifetime diagnosis of melanoma from January 1, 1970, through December 31, 2009, in Olmsted County. The incidence of melanoma and the overall and disease-specific survival rates were compared by age, sex, year of diagnosis, and stage of disease. Results From 1970 through 2009, age- and sex-adjusted incidence increased significantly (P<.001) from 17.0 (95% CI, 8.6-25.4) to 124.6 (95% CI, 108.9-140.3) per 100,000 person-years, with a 4-fold increase in women and a more than 11-fold increase in men. In men, incidence rates increased with age (P<.001) and over time (P<.001). In women, incidence rates increased over time (P<.001) but were constant across all age groups studied (P=.90). The dramatic increase in the incidence of melanoma was observed mainly for stages 0 and I tumors in both men and women (>55-fold increase). Disease-specific survival increased across the decades (P<.001); when year of diagnosis was compared to mortality, hazard ratios were 0.94 (95% CI, 0.90-0.99; P=.010) and 0.93 (95% CI, 0.89-0.98; P=.006) for men and women, respectively. Conclusion The incidence of melanoma in older men and women increased significantly over the past 4 decades in Olmsted County, with men experiencing higher rates of increase than did women.