Melanoma death rates will reduce from their current rates by 2050 – but an ageing population will mean that the number of people dying from the disease will continue to be high, a conference has heard.
However, Alice Koechlin, from the International Prevention Research Institute in Lyon, France, told delegates at the European Cancer Congress 2017, in Amsterdam, The Netherlands, that if new treatments are effective, the numbers of deaths could also be slashed.
She said people born between 1900 and 1960 had the greatest risk of dying from melanoma because the dangerous effects of exposure to ultraviolet (UV) radiation from sunlight was largely unknown and health professionals also encouraged people to go out in the sun because it was “beneficial”.
“These beliefs were boosted by observations that exposure to ultraviolet light and sunshine could heal some skin infections and rickets, and by the discovery of vitamin D,” she said.
“It was common for babies and school children to be treated with commercial UV radiation-emitting devices and exposed, unclothed, to the midday sun. This fashion faded in the 1960s as effective treatments, such as vaccines and antibiotics, became available and people became aware that sun exposure and sunburn during childhood were strong risk factors for developing skin cancer in later life.”
Using statistical modelling, the researchers examined current cancer death rates to establish if they were due more to the effects of age, the year of birth or to the recent introduction of new medical technologies or treatments.
They used the models to estimate the numbers of deaths from melanoma between 2014-2050 in Australia, the USA and Sweden.
They produced two estimates, one that was based on the assumption that there was no available effective treatment for melanoma, and the second that assumed a treatment was available that resulted in a 25% reduction in melanoma deaths from 2015 onwards.
They found that death rates from melanoma peaked in about 2015 for Australian men and 1990 for Australian women, about 2005 and 1995 for US men and women respectively, and 2010 in both Swedish men and women.
The researchers predicted that in 2050 death rates in Australia would be two-fold lower than in the peak years, while in the USA, rates would be two and a half to three times lower than in the peak years. In Sweden, the 2050 rates would be one and a half times lower than in peak years.
They warned that the ageing populations would mean deaths from melanoma would continue to increase until 2030-2035.
“Our findings clearly show that most of the death toll due to melanoma has been caused by medically backed exposures to highly carcinogenic UV radiation between 1900 and 1960,” Ms Koechlin said.
“They also show that UV-protection of children pays off because rates of melanoma death keep going down from around 1960 to the current day as the UV protection of children based on clothing, shading and avoidance of excessive sun exposure has spread in most light-skinned populations, starting in Australia.
“Skin screening, based on the opportunistic early detection of skin cancers, does not affect melanoma mortality and our analyses confirm this evidence. So, generations that have been over-exposed to high UV doses keep the high probability of developing a deadly melanoma at some stage in their lives.
“The good news is that the risk declines rapidly as skin protection increases, and that effective treatments are starting to be available. But we still have a long way to go before we will have affordable therapies able to prolong survival from advanced melanoma by several years with a decent quality of life.”
* Ms Koechlin reported a second study undertaken in Italy and Belgium highlighting the link between diagnosis of pancreatic cancer and that of type 2 diabetes.
The study showed that 50% of cancer patients had been diagnosed with type 2 diabetes in the previous year.
The researchers say the findings show that doctors should be aware of the link. However they could not establish whether the diabetes may indicate early stage cancer – or whether anti-diabetes incretin therapies trigger the disease.
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