Increased Incidence of in Situ and Invasive Melanoma in Denmark

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Neel Maria Helvind, MD

In a study reported in JAMA Dermatology,1 Neel Maria Helvind, MD, of the University Hospital Rigshospitalet, Copenhagen, Denmark, and colleagues analyzed the increases in melanoma incidence seen in Denmark between 1985 and 2012. Over that time, the incidence of malignant melanoma doubled to rates of 29.5 and 31.7 per 100,000 person-years in men and women.

Annual Increases

The analysis included 3,299 cases of in situ melanoma and 20,760 cases of malignant melanoma registered in the Danish Melanoma Group database. The estimated annual increase in incidence of malignant melanoma was 4.5% in men and 4.3% in women; the increases were largest in patients older than age 60 (5.8% in men, 4.8% in women), women between the ages of 21 and 30 (6.0%), those who had melanoma with Breslow thickness < 0.75 mm (6.6% in men, 6.1% in women), and those with superficially spreading malignant melanoma (5.2% in men, 4.7% in women). There was no significant annual increase in incidence of melanoma with Breslow thickness > 2.00 mm in women. Relative ulceration rates exhibited an annual decline (–3.3% in men, –3.4% in women). Overall, there was a shift in distribution toward spreading malignant melanoma (P < .001 for both sexes).

The estimated annual increase in incidence of in situ melanoma was 14.0% in men and 11.6% in women, with large increases in men aged older than age 60 (14.3%) and women between the ages of 21 and 30 (14.2%).

The estimated annual changes in malignant melanoma–related mortality were a 0.6% increase (95% confidence interval [CI] = 0.1%–1.2%) in men and a nonsignificant 0.4% decrease (95% CI = –1.0% to 0.3%) in women.

The investigators concluded: “This study confirms a worldwide increase in melanoma incidence. Results may indicate the importance of secondary melanoma prevention in Denmark. Future efforts could intensify primary prevention aimed at young adults, adolescents, and children and maintain and target secondary prevention at the population older than 60 years.” ■

Disclosure: The authors reported no potential conflicts of interest.


  1. Helvind NM, Hölmich LR, Smith S, et al: Incidence of in situ and invasive melanoma in Denmark from 1985 through 2012: A national database study of 24,059 melanoma cases. JAMA Dermatol 151:1087-1095, 2015.