Aging US Population Drives Brisk Increase in Merkel-Cell Carcinoma


By Megan Brooks

NEW YORK (Reuters Health) - Rates of Merkel-cell carcinoma (MCC) in the United States have increased significantly in the past decade due largely to the aging population, a new study confirms.

“MCC is rare, but our research shows that it’s becoming less rare,” Dr. Paul Nghiem of the University of Washington in Seattle said in a statement.

Based on data from the National Cancer Institute's SEER-18 registry, the number of cases of MCC increased 95% between 2000 and 2013, compared with a 57% increase in melanoma and a 15% increase in all solid tumors, he and his colleagues found.

By current estimates, about 2,500 new cases of MCC occur each year in the U.S. This number is expected to rise to roughly 3,250 cases annually by 2025 based on the well-known ties between advancing age and MCC, they say.

Dr. Nghiem presented the study February 16 at the American Academy of Dermatology annual meeting in San Diego, California. The study is published in the March issue of the Journal of the American Academy of Dermatology.

The incidence of MCC will likely continue to rise as the Baby Boomer generation enters the higher-risk age groups for MCC, Dr. Nghiem noted in a phone interview with Reuters Health.

“This growing impact combined with the rapidly evolving therapeutic landscape warrants expanded awareness of MCC diagnosis and management,” Dr. Nghiem and colleagues write in their article.

“Because of its high propensity for spread, the need for adjuvant radiation in many cases, and the clear role for early immunotherapy in the metastatic setting, both early detection and optimal management will be critical for improved outcomes,” they say.

“MCC is really different than any of the other kinds of skin cancers - melanoma or the more common squamous- and basal-cell carcinoma - in that it spreads very often and is very aggressive, so it is really important to recognize it and get treated properly by experienced doctors,” Dr. Nghiem told Reuters Health. “There are a few dozen expert groups in the U.S. that are really familiar with managing this cancer and a consultation at one of those centers is important.”

While melanoma appears on the skin as a dark mole, MCC typically appears as a firm lump that is red, purple, or skin-colored. Many patients can mistake MCC for a cyst or folliculitis, Dr Nghiem noted.

With MCC, “the initial bump on the skin is pretty boring looking and a lot of patients are told by quite competent doctors not to worry about it, but more than half of these cancers by the time of diagnosis will have already spread to the lymph nodes or beyond,” Dr. Nghiem said.

“But caught early and managed well, the outlook for MCC very good. Truly caught early, the chance of beating this cancer is better than 90%,” he said.


J Am Acad Dermatol 2018.

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