Highlights
- •Currently, the highest incidence rates have been observed in Australia, New Zealand and the United States.
- •Latitude closer to the equator in North America is associated with the Merkel cell carcinoma (MCC) incidence in men.
- •Body site distribution of MCC was associated with sex, age, and ethnicity.
- •Blacks have a substantially higher proportion of anogenital MCC.
Abstract
Aim
The aim of this article was to provide worldwide, population-based incidence rates
for Merkel cell carcinoma (MCC).
Methods
We included 11,576 cases from 20 countries for time trend analyses (1990–2007) and
11,028 cases (2.5 billion person-years) from 21 countries for the period 2003–2007
extracted from Cancer Incidence in Five Continents. We computed age-standardised incidence
rates (World Standard population) per million person years and sex ratios of these
rates. We estimated annual percentage changes (EAPCs) of the incidence and studied
the association between geographic latitude and MCC incidence. We examined the body
site distribution of MCC.
Findings
In the majority of populations, the incidence has increased over time (EAPC, men 2.0–21.0%;
women 1.6–27.2%). Rate differences between 1995 and 2007 were typically small (men:
0.8–2.2; women: 0.2–1.7). The incidence was relatively stable in some populations
(men: U.S. blacks, Japan, Norway, Denmark; women: Denmark, Norway, Sweden). Incidences
from 2003 to 2007 were highest in Australia, New Zealand, the United States and Israel
among men and in New Zealand, Australia, Ireland and the Netherlands among women.
The incidence of MCC and melanoma among white non-Hispanic males in North America
was positively associated with living closer to the equator. The proportion of MCC
on the head was higher with advanced age. The head was a less likely primary site
among blacks as compared with any other ethnicity.
Interpretation
Several countries showed increases in MCC incidence among white non-Hispanics over
time. Latitude closer to the equator was associated with the MCC incidence in North
American men, but barely in women, possibly due to occupational sunlight exposure
patterns.
Keywords
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Article info
Publication history
Published online: March 10, 2018
Accepted:
February 1,
2018
Received in revised form:
January 30,
2018
Received:
October 27,
2017
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
