OBJECTIVES: Melanoma of the skin represents 5.5% of all new cancer cases in the United States (US). While incidence continues to increase, overall mortality rates have been steadily declining. We investigated the hospitalization and in-hospital mortality trends of melanoma skin cancer in the US over the most recent period of available data.

METHODS: Using 2012-2016 data from the National Inpatient Sample, admissions with a diagnosis of melanoma of the skin were identified. Descriptive measures including demographics, length of stay (LOS), discharge disposition, and total cost (adjusted for inflation using medical care component), stratified by year. Discharge-level weights applied to represent national estimates, and domain analysis used for subpopulation estimates. Annual percentage change calculated to characterize the trend in hospitalization rates over time.

RESULTS: In 2016, there were 142,050 admissions of patients with a diagnosis of melanoma skin cancer. Mean (95% confidence interval) age was 70.2 (69.6-70.5) years. Patients were predominantly White (90.8% [89.5%-92.0%]) and covered by Medicare (68.3% [67.4%-69.3%]). Mean age increased each year from 68.9 (68.4-69.3) in 2012 (p<0.001). Hospitalization rates increased from 37 per 100,000 people in 2012 to 44 per 100,000 people in 2016, with an average annual increase of 5.0% (3.2%–6.9%; p=0.003). Mean LOS remained relatively consistent each year from 4.6 (4.5-4.7) in 2012 to 4.6 (4.6-4.7) in 2016 (p=0.053). In-hospital mortality occurred in 2.6% (2.4%-2.8%) of admissions in 2012 and 2.7% (2.6 %-2.9%) in 2016 (p=0.856). The mean cost of admission remained consistent with only a slight decrease from 2012 ($14,473 [$13,975-$14,972]) to 2016 ($14,041 [$13,613-$14,469]) (p=0.782).

CONCLUSIONS: While the admission rates of melanomas of the skin increased significantly from 2012-2016, hospital mortality rates and costs remained stable in the US. Melanoma skin cancer mortality dropped 2.5% per year over a similar period, suggesting earlier diagnosis and detection, and improved treatment in the outpatient setting.