OBJECTIVES: To identify all newly diagnosed patients with malignant melanoma during 2015 across all hospitals in England, using proxy markers to define stage in order to determine patient eligibility for new advanced treatments.

METHODS: A retrospective observational study based on secondary use of patient-level data obtained from the Hospital Episode Statistics (HES) database in England. Patients who had an initial ICD-10 diagnosis code for malignant melanoma (C43) during 2015 were included in the analysis. Stages were categorised according to clinically defined proxy markers, taking into account relevant procedures, treatment and diagnosis codes.

RESULTS: A total of 11,444 patients presented with malignant melanoma during 2015 in England. Of these, 4,316 were stage I or II and assumed cured, 540 were stage III or IV (excision/ re-excision with node involvement), 712 were stage III or IV who progressed to advanced disease (additional record of metastasis), and 2,393 were stage IIC/IV with no evidence of disease for 12 months (no further surgery, biopsy, node involvement, chemotherapy or radiotherapy) . Of all patients diagnosed in 2015, 1,138 received chemotherapy, whilst 1,407 died before 2018. NHS CCGs with the most newly presenting melanoma patients in 2015 included Oxfordshire, North, East and West Devon, and Cambridgeshire and Peterborough. Oxford University, Newcastle Upon Tyne, and St Helens and Knowsley Hospitals were the providers with the highest number of newly diagnosed patients.

CONCLUSIONS: The HES database can be used to determine the incidence and location of patients with a condition. In the absence of a specific ICD-10 code, proxy markers can be clinically defined to determine more specific disease sub-populations (e.g. disease stage). This is useful during early development to help identify potential clinical trial subjects, and during later stage development/ post-approval to help inform the national, regional and local NHS budget impact of new advanced treatments.