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March 30, 2022

Melanoma Epidemiology—Pivoting to Low- and Middle-Income Countries

Author Affiliations
  • 1Center for Health Outcomes and PharmacoEconomic Research; R. Ken Coit College of Pharmacy; The University of Arizona, Tucson
JAMA Dermatol. 2022;158(5):489-491. doi:10.1001/jamadermatol.2022.0162

In 2012, the world population stood at 7.125 billion,1 and that year, according to the GLOBOCAN 2012 database, 230 000 people were diagnosed as having cutaneous melanoma and 55 000 people died of the disease.2 The results from GLOBOCAN 2020 reported by Arnold et al—most of whom are scientists with the International Agency for Research on Cancer (IACR)—in this issue of JAMA Dermatology3 are sobering: an estimated 325 000 new cases and 57 000 deaths for a world population that increased from 2012 by 9.4% to 7.795 billion.1 Between 2012 and 2020, the incidence of cutaneous melanoma increased by a staggering 41.3%, while the mortality increased 3.6%. Using a cautious approach pegged to demographic projections, the study by Arnold et al3 also estimates that in 2040, there will be 510 000 new cases and 96 000 deaths against a world population estimated to total 9.199 billion.1 Likely, in affluent regions of the world with high melanoma rates, the discordance between incidence and mortality—observed or projected—may reflect more intense melanoma surveillance and increased diagnostic scrutiny; that is, the “combined effect of more screening skin examinations, falling clinical thresholds to biopsy pigment lesions, and falling pathological thresholds to label the morphologic changes as cancer.”4 There is indeed an emergent sentiment about overdiagnosis of melanoma that should be considered when interpreting melanoma statistics.5

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