Trends in Melanoma Incidence, Prevalence, Stage at Diagnosis, and Survival: An Analysis of the United States Cancer Statistics (USCS) Database

Background and objectives Melanoma, a major skin cancer, has seen varying trends in incidence, prevalence, stage at diagnosis, and survival. This study examines these trends using the United States Cancer Statistics (USCS) database, covering the period from 1999 to 2021. Methods We extracted data from the USCS database, which integrates the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program and the Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries (NPCR). The analysis included new melanoma cases, prevalence estimates (using a 20-year limited duration), stage at diagnosis, and five-year relative survival rates. Incidence rates were adjusted for age using the 2000 United States standard population. Descriptive and trend analyses were performed using IBM SPSS Statistics software, version 29 (IBM Corp., Armonk, NY).  Results The analysis of melanoma trends from 1999 to 2021 reveals a significant increase in the annual age-adjusted incidence rate, rising from 15.1 per 100,000 (95% CI: 14.9- 15.2) in 1999 to 23.0 per 100,000 (95% CI: 22.8- 23.1) in 2021. This upward trend is consistent across gender and racial/ethnic groups. The prevalence of melanoma over a 20-year period was 0.279 (95% CI: 0.276-0.282), with males showing a higher prevalence (0.302, 95% CI: 0.298-0.306) compared to females (0.256, 95% CI: 0.252-0.260). The distribution of melanoma stage at diagnosis indicated that 77% of cases were localized (95% CI: 76.5-77.5%), 9.5% regional (95% CI: 9.2-9.8%), 4.7% distant (95% CI: 4.4-5.0%), and 8.8% unstaged (95% CI: 8.5-9.1%). Survival analysis showed a five-year relative survival rate of 99.4% (95% CI: 99.2-99.6%) for localized melanoma and 35.6% (95% CI: 33.7-37.6%) for distant melanoma, highlighting significant disparities in survival based on stage at diagnosis. Conclusions The study highlights a rising incidence of melanoma and emphasizes the critical role of early detection in improving survival outcomes. The findings underscore the effectiveness of early diagnosis and the necessity for ongoing efforts to improve melanoma outcomes across diverse populations.