BSV06 The national epidemiology of genital melanoma in England: 2013–2022

Abstract

Genital melanomas are rare cancers associated with diagnostic delays, limited evidence-based management and poor outcomes. This study describes the incidence, demographics, routes to diagnosis, management and survival of patients with genital cutaneous melanoma in England from 2013 to 2022. Data were obtained from the National Disease Registration Service. Crude incidence rate and European age- and gender-standardized incidence rates (EASR) are reported per 100 000 person-years. Deprivation is reported by Index of Multiple Deprivation (IMD) quintiles, and comparisons were made using the χ2-test in MedCalc software. Between 2013 and 2022, counts were stable, with annual cases ranging from 50 to 70. The crude incidence rate varied between 0.09 and 0.12 per 100 000 person-years and the EASR ranged from 0.09 to 0.13, with overlapping 95% confidence intervals (CIs). The female-to-male ratio was approximately 7 : 1 (87.3% female, 12.7% male; corresponding to a difference of 74.5%, 95% CI 64.7–80.8, P < 0.001). Cases were predominantly diagnosed in older adults, with the highest burden among those aged > 55 years. Self-reported ‘White’ ethnicity (93.1%) was most common, with small numbers recorded in combined other ethnic groups (3.7%) and 3.2% of unknown ethnicity. The proportion of cases was higher in less deprived quintiles (IMD 1 and 2 vs. 4 and 5) (10.7% difference with 95% CI 1.7–19.3; P = 0.02). Most cases were diagnosed via the urgent suspected cancer pathway (54.5%), followed by ‘other GP’ (32.6%), emergency presentation (4.0%) and ‘unknown’ (3.4%) pathways. Definitive surgical management predominated (88%). Use of systemic anticancer therapy increased over time (from 10% in 2013 to 35.9% in 2022). The 5-year net survival estimate (2015 cohort) was 53.6% (95% CI 37.2–70.0) and the overall survival was 47.3% (95% CI 33.7–59.7). Genital melanoma is a rare cutaneous malignancy in England; it is more common in female patients and the incidence appears stable. Survival outcomes are poor, highlighting the need for increased awareness to support earlier recognition and improved outcomes.