Prepared by: Victoria Zakrajšek, Tatjana Kofol Bric 
Date of last change: February 2020

Purpose and justification of the indicator

Skin cancer is the most common cancer in humans. It is divided into melanoma and non-melanoma. Malignant melanoma accounts for about 5% of all skin cancers and is responsible for more than 90% of all skin cancer deaths. Melanoma is not one of the most common types of cancer, but its incidence has been rising the fastest among all cancers in recent decades. The incidence is highest in Australia and New Zealand. In Europe, the incidence increased somewhat more slowly and mainly among the population, which often spends its holidays in warm places. In Slovenia, in the period 2012-2016, an average of 549 people a year were newly diagnosed with malignant melanoma of the skin. The risk is greatest in the central and western part of the country.
Risk factors for the development of melanoma are a positive family history, a greater number of pigmented marks (more than 50), atypical marks (larger than 6 mm with irregular edges and uneven pigmentation), congenital marks, past melanoma, exposure to UV rays (it is particularly dangerous intense sunbathing during vacation and use of solariums) and sunburns, age, race and skin type (melanoma occurs mainly in the white race and mainly in people with fair skin types), Xeroderma pigmentosa (a rare hereditary disease).
The phenomenon is closely related to lifestyle, namely the practice of popular outdoor activities and recreation, wearing clothes that are increasingly open and the popularity of tanned skin, all of which can lead to excessive exposure to the sun. Experts believe that the harmful effects of UV radiation could be avoided and four out of five cases of skin cancer could be prevented by taking appropriate self-protective measures. Experience around the world shows that the behavior of the population can be influenced by extensive health education campaigns. As an effort to improve the situation due to the alarming epidemiological data on the increase in the number of skin cancers, the Safe in the Sun program has been implemented in Slovenia since 2007. The central activity of the Sun Safe program is to educate preschool children and schoolchildren about the harmful effects of the sun's rays and, above all, about the protective measures that can be used to effectively prevent these effects or we reduce.
The local community can contribute a lot to raising awareness among residents about the factors that cause the formation of malignant melanoma and to creating conditions so that residents can also put protective measures into practice. Above all, various activities are needed to warn residents of the dangers of excessive sunbathing and the necessary protection when working outdoors.

Definition of indicator

The incidence rate of malignant melanoma of the skin shows the average annual incidence of malignant melanoma per 100,000 inhabitants in the observed five-year period. An age-standardized rate is calculated, which enables mutual comparison of populations with different age structures.

Unit of measure

Age-standardized rate per 100,000 inhabitants.

Calculation of the indicator

The incidence rate of malignant melanoma of the skin is the ratio between the number of new cases of malignant melanoma in the observed population in one calendar year and the number of inhabitants in the observed population in the middle of the same calendar year, multiplied by 100,000.
The disease category according to the IKB-10 classification, which is included in the calculation, is C43.
New cases of malignant melanoma
<math xmlns="http://www.w3.org/1998/Math/MathML"><mo>=</mo><mfrac><mrow><mi>T</mi><mi>h</mi><mi>e</mi><mo>&#160;</mo><mi>n</mi><mi>u</mi><mi>m</mi><mi>b</mi><mi>e</mi><mi>r</mi><mo>&#160;</mo><mi>o</mi><mi>f</mi><mo>&#160;</mo><mi>n</mi><mi>e</mi><mi>w</mi><mo>&#160;</mo><mi>c</mi><mi>a</mi><mi>s</mi><mi>e</mi><mi>s</mi><mo>&#160;</mo><mi>o</mi><mi>f</mi><mo>&#160;</mo><mi>m</mi><mi>a</mi><mi>l</mi><mi>i</mi><mi>g</mi><mi>n</mi><mi>a</mi><mi>n</mi><mi>t</mi><mo>&#160;</mo><mi>m</mi><mi>e</mi><mi>l</mi><mi>a</mi><mi>n</mi><mi>o</mi><mi>m</mi><mi>a</mi></mrow><mrow><mi>T</mi><mi>h</mi><mi>e</mi><mo>&#160;</mo><mi>n</mi><mi>u</mi><mi>m</mi><mi>b</mi><mi>e</mi><mi>r</mi><mo>&#160;</mo><mi>o</mi><mi>f</mi><mo>&#160;</mo><mi>i</mi><mi>n</mi><mi>h</mi><mi>a</mi><mi>b</mi><mi>i</mi><mi>tan</mi><mi>t</mi><mi>s</mi><mo>&#160;</mo><mi>i</mi><mi>n</mi><mo>&#160;</mo><mi>t</mi><mi>h</mi><mi>e</mi><mo>&#160;</mo><mi>o</mi><mi>b</mi><mi>s</mi><mi>e</mi><mi>r</mi><mi>v</mi><mi>e</mi><mi>d</mi><mo>&#160;</mo><mi>p</mi><mi>o</mi><mi>p</mi><mi>u</mi><mi>l</mi><mi>a</mi><mi>t</mi><mi>i</mi><mi>o</mi><mi>n</mi></mrow></mfrac><mo>&#215;</mo><mn>100</mn><mo>.</mo><mn>000</mn></math>
The direct standardization method is used to calculate the age-standardized rate, where the Slovenian population from 2014 is used as the standard population. The incidence rate of malignant melanoma is shown as an average of five consecutive years.

Data sources for Slovenia

Cancer Registry of the Republic of Slovenia, Institute of Oncology
Population, Statistical Office of the Republic of Slovenia.

Time availability

Data on the incidence of malignant melanoma are published annually.

Men in literature

<ol>
<li>Oncology Institute Ljubljana <a href="https://www.onko-i.si" target="_blank" rel="noopener">https://www.onko-i.si</a> (07.02.2020).</li>
<li>Cancer in Slovenia 2016. Ljubljana: Oncology Institute Ljubljana, Cancer Epidemiology and Registry, Cancer Registry of the Republic of Slovenia, 2019.</li>
<li>Epidemiology of malignant melanoma. M. Primic Žakelj, T. Žagar, V. Zadnik. Radiol Oncol 2007; 41(Suppl 1): S1-S12.</li>
<li>National Institute of Public Health. Safe with the sun. <a href="https://www.nijz.si/sl/varno-s-soncem" target="_blank" rel="noopener">https://www.nijz.si/sl/varno-s-soncem</a> (17.02.2020)</li>
<li>National Institute of Public Health. Center for Health Ecology. Ultraviolet radiation and health. <a href="https://www.nijz.si/sl/ultravijolicno-uv-sevanje-in-zdravje" target="_blank" rel="noopener">https://www.nijz.si/sl/ultravijolicno-uv-sevanje-in-zdravje</a> (17.02.2020).</li>
</ol>

Health status

Prepared by: Metka Zaletel 
Date of last modification: September 2016

Residents and community

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: January 2018

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: September 2016

Prepared by: Mojca Simončič 
Date of last change: March 2017

Prepared by: Gregor Starc 
Date of last modification: September 2016

Health risk factors

Prepared by: Gregor Starc, Kristina Orožen 
Date of last change: September 2016

Prepared by: Tina Lesnik 
Date of last change: March 2021

Prepared by: Andreja Belščak 
Date of last change: September 2016

Prepared by: Mateja Rok Simon and Tina Zupanič 
Date of last change: March 2017

Prepared by: Metka Zaletel 
Date of last modification: March 2019

Prepared by: Victoria Zakrajšek 
Date of last change: March 2021

Prepared by: Martin Ranfl, Jona Bambič 
Date of last change: November 2017

Prepared by: Victoria Zakrajšek, Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Jasmina Staroveški Anderlič 
Date of last change: March 2020

Prepared by: Victoria Zakrajšek 
Date of last change: November 2021

Prepared by: Victoria Zakrajšek 
Date of last change: March 2023

Prepared by: Tatjana Kofol Bric 
Date of last modification: September 2016

Preventive

Prepared by: Victoria Zakrajšek and Sonja Tomšič 
Date of last change: March 2017

Prepared by: Bonia Miljavac 
Date of last change: March 2017

Prepared by: Sonja Tomšič 
Date of last change: November 2019

Prepared by: Sonja Tomšič 
Date of last change: March 2021

Prepared by: Victoria Zakrajšek 
Date of last change: March 2017

Prepared by: Aleš Korošec 
Date of last change: September 2016

Prepared by: Aleš Korošec
Date of last change: September 2016

Prepared by: Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Aleš Korošec and Sonja Tomšič 
Date of last change: September 2016

Prepared by: Mojca Simončič and Metka Zaletel 
Date of last change: October 2019

Prepared by: Kristina Orožen 
Date of last change: March 2019

Prepared by: Tatjana Kofol Bric, Jona Bambič 
Date of last change: March 2018

Prepared by: Ema Ahačič 
Date of last change: April 2023

Prepared by: Ema Ahačič 
Date of last change: March 2023

Mortality

Prepared by: Sonja Tomšič, Tatjana Kofol Bric 
Date of last change: March 2019

Prepared by: Sonja Tomšič 
Date of last change: March 2019

Prepared by: Tina Lesnik 
Date of last change: March 2019

Prepared by: Tina Lesnik 
Date of last change: March 2020