Melanoma epidemiology of Austria reveals gender-related differences

Background. Cutaneous melanoma shows gender-specific trends worldwide, with highest rates in older men. In Austria, women show greater knowledge about the early detection of skin cancer by screening. Our aim was to analyse national melanoma incidence and mortality rates with regard to gender to improve our prevention efforts. Methods. Population-based incidence (1983-2008) and mortality (1970-2010) data were retrieved from the Austrian cancer registry. ICD 9/10 Codes (172/C43) were used for melanoma. Stages were defined by the TNM classification. Age-standardized rates were calculated using the direct method (2000 WHO standard population) and linear regression models were used to estimate trends. Results. Age-standardized incidence rates of melanoma increased for both genders from 4.9 in 1983 to 10.5 in 2008 (P<0.001), for men more than women (P<0.005). In 2006-2008 the lifetime risk of developing a melanoma was 1:123 (women: 1:128, men 1:117). In-situ and local stages were more common in women, men presented with regional and distant disease. In 2008-2010 male mortality was 1.7 times higher than female (P<0.005) and the lifetime risk of death from melanoma amounted to 1:570 (women 1:705, men 1:434; P<0.05). Comparatively, men over 75 faced the highest risk of presenting with or dying from melanoma. Conclusion. In Austria, melanoma epidemiology showed gender-specific differences. Efforts in early detection need to be increased in elderly men. As shown in the female population, a change in the melanoma-related epidemiology is feasible, most likely by means of secondary prevention.