Importance Men and women develop melanoma at different rates on different body sites, with variation across countries, but explanations for these disparities remain elusive.

Objective To test whether observed differences in melanoma incidence between men and women vary by population, age, or anatomic site.

Design Cross-sectional analysis of sex- and site-specific temporal trends in melanoma incidence over 3 decades was conducted for men and women diagnosed with invasive melanoma in the US (limited to white race), Canada, Australia, New Zealand, the UK, Sweden, Norway, and Denmark. Using cancer registry data, male to female incidence rate ratios (IRRs) were calculated overall and by anatomic site, and Joinpoint regression models were used to estimate the annual percentage rate changes in sex- and site-specific incidence in each population. Incidence rates were standardized to the US 2000 population. Data on the incidence between January 1, 1982, and December 31, 2015, were obtained; analysis was conducted from March 1 to October 15, 2019.

Main Outcomes and Measures Male to female IRRs and annual percentage change in rates.

Results Total melanoma incidence was higher in men than women in US individuals (limited to white race), Canada, Australia, and New Zealand, but not in Denmark, the UK, Norway, and Sweden. In all populations, men had higher rates of melanoma of the head and neck and trunk than women (male to female IRR >1), but lower melanoma rates on the lower limbs (ie, male to female IRR approximately 0.5). The male to female IRR increased log linearly with age, with excess melanomas in women younger than 45 years in all populations (eg, IRR for 20-24 y age group, 0.3 in Denmark and 0.7 in Australia), and excess melanomas in men older than 69 years (eg, IRR for 70-74 y age group, 1.1 in Denmark and 2.1 in the US white population). The age at which the melanoma incidence in men exceeded the melanoma incidence in women differed by population, being achieved the earliest in Australia (45-49 years) and latest in Denmark (65-69 years).

Conclusions and Relevance In predominantly fair-skinned populations, melanoma incidence appears to differ systematically and consistently between men and women by age and anatomic site.

重要性 男性和女性在不同的身体部位以不同的速度发展黑色素瘤，但各国之间存在差异，但对这些差异的解释仍然难以捉摸。

目的 测试观察到的男女之间黑色素瘤发生率的差异是否因人口，年龄或解剖部位而异。

设计 在美国（仅限于白人），加拿大，澳大利亚，新西兰，英国，瑞典，挪威和丹麦。使用癌症登记数据，总体和按解剖部位计算男女发病率之比（IRR），并使用Joinpoint回归模型估算每个人群中性别和部位特异性发病率的年百分比变化。发病率是根据美国2000年人口标准化的。获得了1982年1月1日至2015年12月31日之间的发病率数据；分析于2019年3月1日至10月15日进行。

主要成果和衡量指标 男女内部收益率和比率的年度百分比变化。

结果 在美国（限于白人），加拿大，澳大利亚和新西兰，男性中黑色素瘤的总发病率高于女性，但在丹麦，英国，挪威和瑞典则没有。在所有人群中，男性头颈部和躯干黑色素瘤的发生率均高于女性（男性对女性的IRR> 1），但下肢的黑色素瘤的发生率较低（即男性与女性的IRR约为0.5）。男女IRR随年龄线性增加，所有人群中年龄小于45岁的女性黑色素瘤过多（例如，20-24岁年龄组的IRR，丹麦为0.3，澳大利亚为0.7），男性年龄更大的黑色素瘤超过69岁（例如70-74岁年龄段的内部收益率，丹麦为1.1，美国白人为2.1）。男性的黑色素瘤发病率超过女性的黑色素瘤发病率的年龄因人群而异，

结论和相关性 在以皮肤白皙为主的人群中，黑色素瘤的发病率似乎在性别和年龄，性别和性别上均存在系统性差异。