Uveal melanoma in England: trends over time and geographical variation.
Keenan TD., Yeates D., Goldacre MJ.
AIMS: Uveal melanoma is the commonest primary intraocular malignancy in adults, and leads to death in approximately half of patients. The aim was to report on trends over time and geographical variation in rates of uveal melanoma in England. METHODS: Analysis of admissions for uveal melanoma, using linked English national hospital episode statistics, available from 1999 to 2010, and the Oxford record linkage study (ORLS), before that, from 1979 to 1998. RESULTS: The annual rate of people admitted in England with a new record of uveal melanoma remained stable at approximately 1.0 people per 100 000 population from 1999 to 2010. Annual ORLS incidence rates were also stable from 1979 to 1998. Proportions of new uveal malignancies in adults for 2006-10 were 88% (382 people/year) choroidal and 12% (52) ciliary body/iris. Incidence rates increased with increasing age and were higher in men than women. Geographical analysis showed variation across local authorities (LA) in incidence rates, from 0.1 to 1.9 people per 100 000 population per year. Incidence rates at the LA level were inversely correlated with the proportion of black (r=-0.18) or Indian individuals (r=-0.13) in each LA, were weakly correlated with LA levels of social deprivation (r=0.08) and were not correlated with southerly latitude. CONCLUSIONS: The annual incidence of uveal melanoma in England has remained stable over the past decade. This contrasts with the rising incidence of cutaneous melanoma. Our data do not support the possibility that ultraviolet light exposure contributes to the pathogenesis of uveal melanoma.