• Elliott H Campbell, Jacob P Reinhart, Olivia M Crum, Sydney L Proffer, Amy Weaver, Lawrence E Gibson, Jerry D Brewer, and Addison M Demer.
• Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, MN. Electronic address: ehcampbell557@gmail.com.
• Mayo Clin. Proc. 2023 May 1; 98 (5): 713722713-722.

ObjectiveTo identify changes in the incidence and mortality of cutaneous melanoma in the fastest-growing segment of the US population, middle-aged adults.Patients And MethodsUsing the Rochester Epidemiology Project, patients aged 40 to 60 years with a first lifetime diagnosis of cutaneous melanoma between January 1, 1970, and December 31, 2020, while a resident of Olmsted County, Minnesota, were identified.ResultsA total of 858 patients with a primary cutaneous first-time melanoma were identified. The overall age- and sex-adjusted incidence rate increased from 8.6 (95% CI, 3.9 to 13.3) per 100,000 person-years in 1970-1979 to 99.1 (95% CI, 89.5 to 108.7) per 100,000 person-years in 2011-2020 (11.6-fold increase). There was a 52.1-fold increase in women and a 6.3-fold increase in men between these 2 periods. In recent years (2005-2009 vs 2015-2020), the incidence has stabilized in men (1.01-fold increase; P=.96) and continues to significantly increase in women (1.5-fold increase; P=.002). Among 659 patients with invasive melanoma, 43 deaths were due to melanoma, and male sex was significantly associated with an increased risk of death (hazard ratio, 2.95; 95% CI, 1.45 to 6.00). A more recent diagnosis of melanoma was significantly associated with a decreased risk of death due to melanoma (hazard ratio, 0.66 per 5-year increase in calendar year of diagnosis; 95% CI, 0.59 to 0.75).ConclusionMelanoma incidence has significantly increased since 1970. During the past 15 years, the incidence has continued to rise in middle-aged women (approximately 50% rise in incidence) but has stabilized in men. Mortality decreased in a linear fashion throughout this time.Copyright © 2022 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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