A national review of merkel cell carcinoma epidemiology in England 2004-2018 (ODR2021_095)

This project aims to report national epidemiological data from England on merkel cell carcinoma (MCC) between 2004 to 2018. Specifically, the total number of people diagnosed with MCC per year and how this varies across age, gender, ethnicity, income, associated cancer, immunosupression and geographical region. This project will report the body location of MCC and how advanced MCC was at diagnosis. Finally the study will report the treatment received and survival in MCC. The above will be assessed between 2004 to 2018 to look for trends.

This study is a retrospective, observational study that will take place at Norfolk and Norwich University Hospital. This project does not involve patient contact.

Cohort inclusion criteria:

All primary tumours with site code ICD10 C44x (non melanoma skin cancer) and morphology codes ICD-0-2 8247, 8246, 8240, 8249, 8041, 8013, 8045 (merkel cell carcinoma and neuroendocrine carcinomas)

Diagnosed between 1/1/2004 and latest available year for analysis

Patients resident in England, all ages, sex and ethnicities

Although a majority will be diagnosed on pathology report, those registered as a result of that recorded on the death certificate will also be used

Cohort exclusion criteria: none

Data will be extracted from the National Cancer Registration dataset on the Cancer Analysis System (CAS) produced by the National Registration and Cancer Analysis Service (NRCAS) in NHS Digital.

In order to access this data, formal approval from PHE office of data requests has been requested (ODR2021_095). Data will be sent in the form of an excel document to KM, JJ, NJL and ZV by email with a password protected link. Data will only be accessed by KM, JJ, NJL, ZV. The analysis period between 2004 to 2018 was chosen because PHE advised this period reflects when the CAS coding system and data collection is consistent.

Analysis plan

STATA will be used for statistical analysis. Crude incidence counts will be reported. Age specific and age standardised rates will be determined. Survival at 1, 5 and 10 years will be reported. We will conduct regression analysis to evaluate the effect of age, gender, ethnicity, deprivation, associated immunosuppression, body location, stage at diagnosis, treatment received and geographical region on incidence and survival.

Published in British Journal of Dermatology as original research (in print issue planned Feb 2023). Oral presentation in main plenary meeting at BAD international conference Glasgow (7/7/22).

As per original application

Improved understanding of epidemiology of MCC - regional variation, incidence and trend analysis, risk factors (patient and tumour), mortality, prognostic markers