title: Merkel Cell Carcinoma: rising incidence in the East of England.
abstract: BACKGROUND
  Merkel Cell Carcinoma (MCC) is an infrequent but highly aggressive skin cancer. Five-year survival rates are poor, as there are high rates of metastases at primary diagnoses. Recurrences are also common. There is controversy about actual incidence rates which vary considerably between developed countries with majority populations of fair skin types.
  
  
  OBJECTIVE
  We report the age-standardized incidence rates of MCC for both males and females from the East of England, and use linear regression analyses to estimate numbers of cases for 2020 and 2025 to aid healthcare planning and allocation of resources.
  
  
  METHODS
  All cases of MCC diagnosed histopathologically between 1stJanuary 2004 and 31stDecember 2013 were extracted from the databases of the Eastern Office, National Cancer Registration Service, Public Health England, and the Pathology department of the Norfolk and Norwich University Hospital, which serves as the tertiary referral centre for the region. Age-standardization incidence rate calculations (ASIs) and linear regression analyses were performed.
  
  
  RESULTS
  The ASIs for males and females were 0.70 and 1.08 per 100 000 person-years respectively. The total age-adjusted incidence rate was therefore 1.78 per 100 000 person-years. The ratio of female: male disease was 3:2. The total number of cases for this region over the time period studied was 73. There has been a threefold increase over this period. Estimated cases for this region are 17 in 2020, and 22 in 2025. Estimated UK cases for 2020 are 920, and 1134 in 2025.
  
  
  CONCLUSIONS
  MCC is increasing steadily in the East of England, and has risen threefold over the last 10 years and is similar to the highest reported rates from Western Australia. These data are 12-fold higher than previous UK estimates, and suggest that the incidence rate is also rising in other regions of the UK.
authors: Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK.
authors: P K C
authors: PK
authors: Goon
authors: National Cancer Registration Service, Public Health England, Cambridge, UK.
authors: D C
authors: DC
authors: Greenberg
authors: Department of Pathology, Norfolk and Norwich University Hospital, Norwich, UK.
authors: L
authors: L
authors: Igali
authors: Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK.
authors: N J
authors: NJ
authors: Levell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015266:Carcinoma, Merkel Cell / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000453:epidemiology*; D055815:Young Adult