Cancer Res Treat.  2022 Jul;54(3):937-949. 10.4143/crt.2021.871.

Incidence and Survival Rates of Cutaneous Melanoma in South Korea Using Nationwide Health Insurance Claims Data

• Kim T
• Yoon S
• Shin DE
• Lee SC
• Oh J
• Lee SY
• Kim DK
• Kim S
• Jung B
• Kim M
• Lee S

• KMID: 2531339
• DOI: http://doi.org/10.4143/crt.2021.871

Abstract

Purpose
Melanoma incidence is rising worldwide along with the associated personal and socioeconomic health expenditures. We investigated the incidence and survival-rate patterns of melanoma in South Korea using nationwide data.
Materials and Methods
This retrospective cohort study included patients with melanoma between 2004 and 2017, based on National Health Insurance (NHI) claims data in South Korea. The incidence, prevalence, and survival rate were analyzed along with baseline demographic characteristics. We collected solar irradiation dose (SID) and healthcare ranking score (HRS) according to the administrative district from the Korea Meteorological Administration and Korea Health Promotion Institute. The incidence and survival rates were assessed using Pearson's correlation, the Kaplan-Meier estimation, multiple linear regression, and multiple logistic regression methods.
Results
Twenty-five thousand, five hundred ninety-one patients with melanoma were diagnosed during the study period. The age-standardized incidence of melanoma steadily increased from 2004 to 2017 from 2.6 to 3.0/100,000/yr. The incidence of melanoma increased with significantly higher income (p < 0.05). The prevalence followed a similar pattern as the incidence. According to multivariate analysis, HRS significantly influenced the incidence of melanoma in high sun-exposed sites (p < 0.001). There was no significant change in annual mortality. Women had a higher 5-year survival rate than men (78.4% vs. 72.8%). Mortality by the administrative district was highly correlated with HRS.
Conclusion
The incidence of melanoma is increasing in South Korea. A low HRS is associated with both higher incidence and mortality. The findings of this study could be utilized as a guideline for treating melanoma patients.

Keyword

Melanoma; Republic of Korea; Incidence; Survival rate; Health promotion

Figure

• 

  Fig. 1 Comparisons between solar irradiation and melanoma incidence during 2004–2017 in South Korea. ( A) Heatmap with the average value of solar irradiation by the district. The scale bar denotes the annual average solar irradiation quantity ( MJ/m2). ( B) Heatmap of melanoma incidence. The melanoma incidence is shown by high sun-exposed sites, low sun-exposed sites, and both together. The scale bar denotes the incidence of melanoma per 100,000/year. (C) Results of the Pearson’s correlation analysis between solar irradiation and melanoma incidence. High sun-exposed sites and low sun-exposed sites were linearly related significantly ( Pearson correlation coefficient 0.702 for high sun-exposed sites and 0.549 for sun and low sun-exposed sites, and 0.637 for high and low sun-exposed sites).

• 

  Fig. 2 Changes in melanoma incidence according to income. As income estimated from insurance premium data increased, melanoma incidence per 100,000/yr also increased (p < 0.05).

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  Fig. 3 Correlation analysis between incidence, mortality, and Korea regional healthcare ranking score (HRS) during 2004–2017 in South Korea. (A) Heatmap with average the value of the regional HRS by the district. The scale bar denotes the HRS evaluated by the Korea Health Promotion Institute. (B) Heatmap of melanoma incidence and mortality. (C) Results of Pearson’s correlation analysis between incidence, mortality, and Korea regional HRS. The correlations were significant (p < 0.001; incidence Pearson’s correlation coefficient [PCC], 0.613 and p < 0.001; mortality PCC, 0.840).

• 

  Fig. 4 The 5-year survival rate of melanoma. Survival analyses result using the Kaplan-Meier method. After the log-rank test, the 5-year survival rate of women was better than that of men (78.4% vs. 72.8%) (p < 0.001). That declined with age (p < 0.001; < 50, 90.6%; 50–79, 75.4%; ≥ 80, 50.2%). Patients with melanoma in low sun-exposed sites had shorter survival than those with melanoma in high sun-exposed sites (p < 0.001; 75.9% vs. 79.4%). The higher income was better survival rate than the lower income (p < 0.001; Q1–5, 72.9%; Q6–10, 74.3%; Q11–15, 74.8%; Q16–20, 74.7%).

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  Fig. 5 Five-year survival rate of melanoma by anatomical locations. Survival analyses result using Kaplan-Meier method. After the log-rank test, the 5-year survival rate of overlapping malignant melanoma of skin (C43.8) was lower than the other anatomical locations in C43 (Malignant melanoma of skin) (64.5%). In D03 (Melanoma in situ), D03.7 (Melanoma in situ of lower limb, including hip) had the lowest survival rate (88.2%).

Reference

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