The epidemiology of skin cancer in Greater Manchester 2017–22: a retrospective cohort study using primary care records

Lana Lai, Ben W.M. Sim, Tracey Farragher, Brian McMillan, Emma McMullen, Zoe C Venables, Zenas Yiu

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

Abstract

Skin cancer is the commonest cancer in the UK, with increasing incidence, creating a significant workload for dermatology departments. Greater Manchester is one of the most populous areas in the UK, and understanding the regional skin cancer trends is vital for healthcare service planning and public health interventions. The Greater Manchester Care
Record (GMCR) holds data from 99.5% of general practices on > 3 million registered patients (Watkinson RE, Williams R, Gillibrand S et al. Ethnic inequalities in COVID-19 vaccine uptake and comparison to seasonal influenza vaccine uptake in Greater Manchester, UK: a cohort study. PLOS Med 2022; 19: e1003932). It was approved for research access for COVID-19 response analysis, which allowed this opportunity to understand the epidemiology of skin cancer in Greater Manchester. This retrospective observational cohort study of the GMCR included cases of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC) and malignant melanoma (MM) registered between January 2017 and December 2022. We calculated the crude incidence rate (IR) per 100 000 person-years by skin cancer type, age group and sex. To avoid duplication, we restricted cases to a timeframe of at least 2 weeks before a subsequent case was counted, based on expert advice and review of the data. The
denominator was the summation of 1 year of follow-up for each registered patient as of December each year. We compared the IR from GMCR to the national cancer registry IR
from the ‘Get Data Out’ skin initiative. We identified 42 370 cases of BCC, 7503 cSCC and 7924 MM between 2017 and 2022, with respective median (interquartile range) ages at diagnosis of 73.3 years (62.3–80.9), 73.6 years (62.2–81.9) and 62.0 years (49.1–73.8); the majority (> 87%) of the population was White. The IR ranged from the lowest at 185, 44 and 36 per 100 000 person-years in 2020 (coinciding with the early stages of the pandemic) to the highest at 265
(2022), 35 (2019) and 54 (2022) per 100 000 person-years for BCC, cSCC and MM, respectively. The incidence rate ratios (95% confidence interval) for 2020 vs. 2019 were 0.79 (0.76–0.81), 0.98 (0.91–1.06) and 0.87 (0.80–0.94) for BCC, cSCC and MM, respectively. The male-to-female ratio was around 1 for BCC and cSCC until age 70 years, after which there was an increasing male preponderance, while for MM the same divergence started at age 50 years. We report lower IRs for both BCC and cSCC compared with England, and a higher IR for MM. We present the epidemiology of skin cancer in Greater Manchester from a novel primary care dataset, showing reductions in IR during 2020 of 21%, 2% and 13% for BCC, cSCC and MM, respectively. We report a lower than expected IR of cSCC, which is a likely underestimate and requires further investigation.
Original languageEnglish
Title of host publicationBritish Journal of Dermatology
Pagesi47
Number of pages1
Volume191
EditionSupplement_1
DOIs
Publication statusPublished - 1 Jul 2024

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