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

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

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
Number of pages10
JournalInternational Journal of Cancer
Publication statusPublished - 2020

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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