TOPLINE:

In a retrospective study, lentigo maligna (LM) progressed to invasive lentigo maligna melanoma (LMM) in approximately 1% of cases over 10 years, with patients more likely to die from other cancers or cardiovascular disease than from melanoma.

METHODOLOGY:

• Researchers conducted a retrospective study using pseudonymised data from the National Disease Registration Service in England for 39,100 patients diagnosed with LM (median age, 74 years) and LMM (median age, 76 years) between 2013 and 2023.
• A total of 40,910 tumours (29,367 LM and 11,543 LMM) were recorded, with the most common site being the head and neck for both LM (77.1%) and LMM (75.6%).
• Outcomes included the incidence of LM and LMM, survival estimates, and the risk for progression from LM to LMM.

TAKEAWAY:

• The age-standardised incidence of LM rose and fell from 2013 to 2019 (from 4.91 to 5.03 per 100,000 person-years), reduced by 34.3% in 2020 and increased in 2023 (incidence rate ratio [IRR], 1.21; 95% CI, 1.15-1.27). The age-standardised incidence of LMM did not change significantly from 2013 to 2019 (from 1.84 to 1.97 per 100,000 person-years), decreased by 24.3% in 2020 and rose sharply in 2023 (IRR, 1.29; 95% CI, 1.19-1.40).
• Melanoma-specific survival was 98.2% (95% CI, 97.8%-98.6%) for LM and 91.7% (95% CI, 90.7%-92.7%) for LMM at 12 years, and all-cause survival was 61.6% (95% CI, 60.4%-62.8%) for LM and 50.7% (95% CI, 48.7%-52.6%) for LMM at 9.5 years.
• The 10-year risk for progression from LM to LMM was 1.0% (95% CI, 0.8%-1.1%), rising to 1.2% (95% CI, 1.0%-1.4%) for lesions on the head and neck, with increasing age and the head and neck location associated with a higher risk for progression.
• Patients with LM were sevenfold more likely to die from a different cancer and almost sixfold more likely to die from cardiovascular disease than from melanoma; similar was the case with patients with LMM (P < .0001 for all).
• Patients with LMM were more likely to die from melanoma than those with LM (hazard ratio [HR], 5.21; P < .001); female sex was associated with a lower risk for death from melanoma (HR, 0.56; P < .001), whereas older age conferred a higher risk.

IN PRACTICE:

"Studies of longer duration are required to accurately identify true risk with and without treatment. Our estimates may be helpful in treatment discussions of LM in adults with limited life expectancy," the authors concluded.

SOURCE:

This study was led by Dimitrios Karponis, Norwich Medical School, University of East Anglia, Norwich, England. It was published online on May 08, 2026, in the British Journal of Dermatology.

LIMITATIONS:

The results of the study may have limited generalisability to more diverse populations as most participants were White. Data from private clinics may not be adequately represented as NHS laboratories submit their data by law, but private clinics do not. The 1-year latency period for progression may have introduced immortal bias. Data on surgical excision margins were not analysed due to incompleteness.

DISCLOSURES:

This study was funded by the Department of Dermatology at Norfolk and Norwich University Hospital. One author reported serving as a project collaborator with Merck (unpaid), Regeneron, and Skin Analytics and a section editor for the British Journal of Dermatology. Another author reported serving as a deputy editor of Clinical and Experimental Dermatology.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.