Merkel Cell Carcinoma and Melanoma: Trends and Survival in the United States

By: Victoria Kuhr, MS
Posted: Tuesday, January 28, 2025

In a comparative study of the incidence of Merkel cell carcinoma and melanoma, Karena D. Volesky-Avellaneda, PhD, of the National Cancer Institute, National Institutes of Health, Rockville, Maryland, and colleagues observed that melanoma exhibited stronger associations with race and ambient ultraviolet (UV) radiation exposure, whereas Merkel cell carcinoma was more likely to arise in the head-and-neck area. Overall, cancer-specific survival was worse for those with Merkel cell carcinoma than for those with melanoma. These findings were published in the Journal of Investigative Dermatology.

This study evaluated the epidemiology and malignant behavior of Merkel cell carcinoma and melanoma using Surveillance, Epidemiology, and End Results 22 Program data, for patients with cancer aged 20 and older from 2000 to 2021. The analysis included case diagnoses and risk factors.

During 2000 to 2021, 19,444 patients with Merkel cell carcinomas and 646,619 patients with melanoma were diagnosed. Of them, 90% of Merkel cell carcinomas and 95% of melanomas were found in non-Hispanic White individuals. Over 70% of Merkel cell carcinomas occurred in people aged 70 or older vs 37% of melanomas. Additionally, 46% of Merkel cell carcinomas and 22% of melanomas were diagnosed in the head-and-neck region. Among non-Hispanic White individuals, ambient UV radiation exposure was associated with melanoma on the head and neck.

The 5- and 10- year cancer-free survival rates for Merkel cell carcinoma were 69% and 66%, respectively, and for melanoma, they were 90% and 86%, respectively. Cancer-specific mortality was higher among patients with Merkel cell carcinoma than in those with melanoma, but it improved in both groups after 2011, when BRAF and checkpoint inhibitors were introduced.

Among 14,560 people with Merkel cell carcinoma and 484,117 with melanoma during 2004 to 2021, over half (55%) of Merkel cell carcinoma tumors were localized; in contrast, a much higher proportion of melanomas were localized (78%). During follow-up, 3,686 (25%) individuals with Merkel cell carcinoma and 50,691 (10%) with melanoma died of the disease.

Disclosure: The study authors reported no conflicts of interest.

Journal of Investigative Dermatology