P077 Ageing and its impact on skin cancer incidence in England, 2013–2022

Abstract

The UK population is projected to rise from 68.3 to 76.6 million from 2023 to 2047 (+12.2%), with those aged > 85 years expected to nearly double in number from 1.7 to 3.3 million (+94.1%). This study assessed trends in skin cancer incidence in England stratified by age and gender. Skin cancers recorded in NHS England’s National Disease Registration Service (NDRS) and publicly published by the Get Data Out programme from 2013–2022 were analysed, including basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC) and malignant melanoma. Crude and age-specific incidence rates (CIRs and ASIRs) were calculated by type, age group (< 80 or ≥ 80 years) and gender. Joinpoint regression trends were assessed, estimating the annual percentage change (APC) and 95% confidence interval (CI). From 2013 to 2022, total skin cancer cases increased from 178 751 to 230 986 (+29.2%). The largest absolute increases were in adults aged ≥ 80 years, particularly men for melanoma (+81.8%) and cSCC (+72.4%). The ASIR in those aged < 80 years remained stable (APC 0.18%, 95% CI 1.53–1.93, P = 0.85). By contrast, the ASIR rose significantly in adults aged ≥ 80 years (APC 2.60%, 95%CI 0.91–4.44, P < 0.001), especially men aged ≥ 80 years (APC 3.40%, 95% CI 1.43–5.46, P < 0.001). The melanoma ASIR increased significantly in both men (APC 3.98%, 95% CI 2.33–5.06) and women (APC 5.32%, 95% CI 3.01–7.95) aged ≥ 80 years, while the ASIR for cSCC rose across all ≥ 80-year age groups, with the largest increases in men aged ≥ 80 years (APC 4.97%, 95% CI 3.56–6.53, P < 0.001). The incidence of BCC was stable for all groups. Skin cancer incidence is increasing more rapidly in adults aged ≥ 80 years. Ultraviolet-related behaviour, living longer with chronic disease or immunosuppression, and perhaps climate change may be accountable. Management of patients in older age groups is complicated by frailty, multimorbidity and polypharmacy, requiring balanced treatment decisions. It is essential that healthcare planning and clinical guidance address the growing burden of cancer in an increasingly frail and comorbid population.