• Comparison of melanoma incidence and trends among youth under 25 years in Australia and England, 1990-2010.

      Wallingford, S; Iannacone, M; Youlden, D; Baade, P; Ives, A; Verne, J; Aitken, J; Green, Adèle C; Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom (2015-05-08)
      White populations in Australia and England share many genetic and phenotypic characteristics due to common ancestry, but Australians experience far higher rates of melanoma due to higher ambient ultraviolet radiation (UVR) levels. To gain insight into the role of UVR on melanoma development early in life, we used national cancer registration data and compared recent incidence rates and long-term trends of primary invasive cutaneous melanoma in Australian and English youth aged 0-24 years diagnosed 1990-2010. Incidence rates and standardized rate ratios (SRRs) with 95% confidence intervals (CIs) for 2006-2010 were calculated and incidence trends across the whole period were examined using JoinPoint regression. In Australian youth, overall melanoma incidence was double that in English youth (2.2 and 1.1 per 100,000, respectively). While melanoma rates were similarly rare among children <10 years in both countries, in subsequent 5-year age groups, incidence was significantly higher in Australia compared to England. Melanoma incidence among 15-24 year olds significantly increased by more than 2% per year in both sexes in England. However, after an initial non-significant increase, Australian rates for this older age group significantly decreased by 6.0% (95% CI, -8.2 to -3.8) per year in females from 1997 and decreased by 12.4% (95% CI, -20.3 to -3.8) per year in males from 2004. Long-standing primary prevention strategies targeted at curbing UVR exposure appear to have been effective in mitigating incidence trends in Australian youth, but decreases in incidence in English youth are yet to be observed.
    • Prevalence of skin cancer and related skin tumors in high-risk kidney and liver transplant recipients in Queensland, Australia.

      Iannacone, M; Sinnya, S; Pandeya, N; Isbel, N; Campbell, S; Fawcett, J; Soyer, H; Ferguson, L; Davis, M; Whiteman, D; et al. (2016-03-08)
      The increased skin cancer incidence in organ transplant recipients (OTRs) is well-known, but the skin cancer burden at any one time is unknown. Our objective was to estimate the period prevalence of untreated skin malignancy and actinic keratoses (AKs) in high-risk kidney and liver transplant recipients and assess associated factors. OTRs underwent full skin examinations by dermatologically-trained physicians. The proportion of examined OTRs with histopathologically-confirmed skin cancer in the 3-month baseline period was estimated. Prevalence ratios (PR) with 95% confidence intervals (CIs) indicated significant associations. Of 495 high-risk OTRs (average age 54, immunosuppressed 8.9 years), 135 (27%) had basal cell carcinoma, squamous cell carcinoma or Bowen Disease (intra-epidermal carcinoma) present and confirmed in the baseline period with respective prevalence proportions of 10%, 11%, and 18% in kidney recipients and 10%, 9% and 13% in liver transplant recipients. Over 80% had AKs present with approximately 30% having >5AKs. OTRs with the highest skin cancer burden were Australian-born; fair-skinned (PR=1.61, 1.07-2.43); reported past skin cancer (PR=3.39, 95% CI=1.93-5.95); and were receiving the most frequent skin checks (PR=1.76, 95% CI=1.15-2.70). In conclusion, high-risk OTRs carry a substantial measurable skin cancer burden at any given time and require frequent review through easily accessible, specialized services.