Incidence, survival, and persistent age and sex disparities in uveal melanoma: A SEER population study (2000–2022).

Abstract

e21538 Background: It is unclear whether population-level incidence and survival for uveal melanoma have changed over time and whether demographic discrepancies persist. We evaluated temporal changes and differences in survival by age, sex, race/ethnicity, and tumor subsite. Methods: Using SEER (2000–2022), we identified primary uveal melanoma of the choroid (C69.3) or ciliary body/iris (C69.4), histology ICD-O-3 8720/3. Age-adjusted incidence (per 100,000; 2000 US standard) was compared between 2000–2004 and 2018–2022. Overall survival (OS) was assessed using Kaplan–Meier estimates of 5-year OS across four eras (2000–2005, 2006–2010, 2011–2015, 2016–2022). Multivariable Cox models evaluated OS by era, age, sex, race/ethnicity, and tumor subsite. Results: Among 5,856 patients (50.1% male), 89.8% had choroidal tumors and 10.2% ciliary body/iris tumors. Incidence rose modestly from 0.24 (95% CI 0.22–0.30) to 0.30 (0.30–0.38) per 100,000 (+0.06; +25%). The relative increase was larger in women (+36.4%) than in men (+13.3%), though the absolute rates were similar. OS improved over time: 5-year OS increased from 72.4% (69.8–75.1) in 2000–2005 to 77.9% (75.4–80.5) in 2016–2022. Recent diagnosis remained independently associated with better survival (HR 0.775, 95% CI 0.669–0.898 vs 2000–2005). Survival declined with age: 5-year OS 89.3% ( < 50) vs 42.3% (≥80); age ≥80 was associated with > 9-fold higher mortality (HR 9.153, 7.771–10.780). Men had worse OS than women (74.6% vs 77.1%; HR 1.179, 1.081–1.286). Ciliary body/iris tumors were associated with poorer survival than choroidal tumors (HR 1.253, 1.090–1.441). Race/ethnicity analyses were limited by small non-White samples. Conclusions: Uveal melanoma incidence increased gradually while survival improved, particularly in recent years. However, marked disparities persist in older patients, men, and those with ciliary body/iris tumors have worse outcomes. Gains in survival have not been evenly distributed. Findings should be interpreted in light of the restricted histologic definition (ICD-O-3 8720/3). Incidence trends (Age-adjusted per 100,000). 2000–2004 2018–2022 Change Overall 0.24 (95% CI 0.22–0.30) 0.30 (0.30–0.38) +25% Male 0.30 0.34 +13.3% Female 0.22 0.30 +36.4%