Incidence and prognosis of cutaneous melanoma in European adolescents and young adults (AYAs): EUROCARE-6 retrospective cohort results

Background: Cutaneous melanoma (CM) is rare in adolescents and young adults (AYA, 15–39 years at cancer diagnosis) and studies on CM in AYAs are scarce. Our aim is to update CM incidence and survival in European AYAs and to compare incidence and survival both with other age groups and over time. 

Methods: We used the EUROCARE-6 database (108 cancer registries; 29 EU countries), calculating incidence rates (IR) per 100,000 individuals/year in the European population (years of diagnosis: 2006–2013), 5-year relative survival (RS), and 5-year RS conditional to surviving the first year after diagnosis, for the follow-up period 2010–2014 (cases diagnosed in 2006–2013). 

Results: The IR of CM in AYA was greater in females than in males, standing at 7. CM IR was higher in the limbs and lower in the head and neck (H&N) and trunk in females compared to males. Five-year RS was 94 % in AYA and 80 % in older age groups. Survival was higher in limb than in H&N and trunk CM. The incidence of CM increased more in older age groups than in AYA. CM survival rose over time for all ages. 

Conclusions: Differences in IR between males and females may be due to different behaviors and CM biology. The increase in survival can be attributed to healthcare improvements, early diagnosis, and locoregional surgical treatments. The incidence trends are reassuring in terms of tumor burden in AYA. Our findings support the idea that CM is more aggressive with increasing age and gender differences partially explain survival differences between age groups.