OBJECTIVES : This review aimed to analyze the epidemiologic and survival trends of malignant melanoma in Nordics pre- and post-approval of ipilimumab (2011), pembrolizumab (2015), and nivolumab (2015).

METHODS : Using the NORDCAN database, we identified the 5-year prevalence and survival rates by gender and country. Additionally, we examined changes in melanoma profile between the pre-immuno-oncology era (1980-2010), the ipilimumab era (2011-14), and the beginning of the PD-1 inhibitors era (2015-16).

RESULTS : The melanoma of skin has seen a rapid increase during 1980-2016 (16,680-115,999 cases), accounting for 6% of all cancer cases in 2016. The number of persons living with diagnosis per 100,000 was highest in Denmark (519.3) followed by Norway (469.7), Sweden (428.2), Finland (315.9), and Iceland (253.6) in 2016. From 1980 through 2010, the prevalence of skin melanoma increased from 24.16 to 63.91 per 100,000 among men and from 31.62 to 74.82 per 100,000 among women. In Denmark, increases were more pronounced; prevalence rates increased about 3.4 fold in the period 1980-2010. Despite the breakthrough approval of ipilimumab, the prevalence rates increased considerably from 2011 to 2014 (68.04-76.27 in men and even more in women, 79.71-90.23) in Nordics. Iceland was the only country to have shown deceleration in prevalence. Post PD-1 approval (2015-16), the prevalence rates continued to increase in Nordics (men: 78.20-80.97; women: 93.32-96.03). The survival rates have been almost linearly increasing between 1980 and 2011 from 48.25% to 85.8% in men and 68.75% to 91.8% in women. All countries converged in terms of survival rates, although Sweden was consistently the top-performing country. The survival rates further improved to 87.2% and 92.6% in men and women, respectively, after the approval of immunotherapies (2012-16).

CONCLUSIONS : The prevalence rates of melanoma increased by about three folds during the study period. However, an improvement in the survival rates was observed after the introduction of immunotherapies.