title: Regional melanoma incidence in England, 1996-2006: reversal of north-south latitude trends among the young female population.
abstract: BACKGROUND
  Melanoma incidence often shows an increasing latitudinal gradient from north to south among white European populations.
  
  
  OBJECTIVE
  To assess emerging regional melanoma incidence patterns in England.
  
  
  METHODS
  All primary invasive cutaneous melanomas diagnosed in England in people aged 10-89 years, in 1996-2006, were ascertained. Age-standardized incidence rates by sex, age and Government Office Region were calculated for the entire population and for the white population only. Rates according to socioeconomic deprivation were further calculated among those aged under 30 years. Regional heterogeneity and latitude and deprivation trends were assessed by Poisson regression and tests for trend.
  
  
  RESULTS
  Overall, melanoma incidence in England was highest in the South West (overall, 18·75; white, 19·03 per 100,000) and lowest in London (overall, 8·85; white, 11·22 per 100,000). Incidence significantly increased with more southerly latitudes in all white adults aged over 30 years (P < 0·0001), except women aged 30-49 years (1·8%, P = 0·10). However, these north-south latitude trends were reversed in white 10-29 year olds, with sex-specific analyses showing an absence of trend in male subjects (2·7%, P = 0·41) and a strong decreasing trend (-9·8%, P < 0·0001) in female subjects. The highest rates in the young female population occurred in the North West (5·46 per 100,000), and specifically in the second most deprived (5·69 per 100,000) and the second most affluent (6·48 per 100,000) groups.
  
  
  CONCLUSIONS
  Melanoma incidence is high in young people in northern England, including among the moderately deprived, reversing the expected north-south incidence gradients. Prevalent sunbed use in northern England and holiday sun exposure abroad may explain these emerging trends.
authors.affiliation: Manchester Academic Health Science Centre, Institute of Inflammation and Repair, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K; Cancer Research U.K. Paediatric and Familial Cancer Research Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, Oxford Road, Manchester, M13 9PT, U.K.
authors.forename: S C
authors.initials: SC
authors.lastname: Wallingford
authors.forename: R D
authors.initials: RD
authors.lastname: Alston
authors.forename: J M
authors.initials: JM
authors.lastname: Birch
authors.forename: A C
authors.initials: AC
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D012042:Registries; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012878:Skin Neoplasms / Q000453:epidemiology*; D012959:Socioeconomic Factors; D055108:Sunbathing; D014195:Travel; D055815:Young Adult