Superficial spreading melanoma: an analysis of 97 702 cases using the SEER database.

ABSTRACT

Superficial spreading melanoma (SSM) is the most common type of melanoma. Large, population-based studies analyzing the incidence and survival of SSM are limited. This retrospective study was designed to evaluate demographic factors influencing the incidence and survival of SSM using a national population-based database. The United States National Cancer Institute's Surveillance, Epidemiology, and End Results registry was used to calculate incidence and disease-specific survival trends for SSM between 1973 and 2012. Patient data were stratified according to age, sex, race, ulceration, thickness, and stage. Of 97 702 patients, 52.66% were men, 94.93% were white, and 38.92% had a primary lesion on the trunk. The overall incidence is 5.987/100 000 and is increasing with an annual percentage change (APC) of 1.42%. Incidence increases with age, peaking at 70-79 years. Men (6.68/100 00, APC 1.78) had a significantly higher incidence than women (5.565/100 000, APC 1.10). A total of 79.16% of SSM are less than or equal to 1 mm and 92.32% are nonulcerated. The overall 5-year survival is 95.30% and is increasing steadily. Women (hazard ratio 0.54), 'other' races (hazard ratio 0.30), those with local disease, those with thin tumors, and those without ulceration had higher survival than their counterparts (P<0.0001). The incidence of this predominantly thin melanoma subtype is on the rise, creating enhanced concern. Primary and secondary prevention techniques should consider the mortality associated with thin melanoma.