Norway’s melanoma epidemic is splitting by generation, 45-year study finds

Norway now records one of the highest melanoma incidence rates in the world, and a sweeping new analysis of four and a half decades of national cancer registry data shows that the epidemic is evolving in a strikingly generational way. The study, published in The Lancet Regional Health – Europe, tracked 60,722 people diagnosed with a first primary invasive melanoma between 1980 and 2024, and found that while incidence among Norwegians under 40 has stabilised or even declined in recent decades, rates among older adults — particularly men — continue to climb at an accelerating pace. The findings offer one of the clearest pictures yet of how changing sun-related behaviours across generations are reshaping skin cancer risk in a fair-skinned northern European population.

The numbers behind the trend are substantial. Among men, melanoma incidence rose from 12.4 cases per 100,000 in 1980 to 35.7 per 100,000 in 2024, while among women it climbed from 15 to 33.6 per 100,000 over the same period. Averaged across the full 45 years, incidence increased by 2.7 percent per year in men and 2.4 percent per year in women. But that headline figure conceals a deep divide by age. In people younger than 40, rates were low and stable or trending downward in both sexes, whereas from age 50 onwards the increases were statistically significant, and the steepest annual rises occurred among those aged 70 and older. Men aged 80 and above saw incidence grow by 5.9 percent per year, and women in the same age group by 4.1 percent per year.

When the researchers split the study period into two halves, 1980–2005 and 2006–2024, the divergence became even sharper. In the most recent period, average annual percent changes were negative or close to zero for everyone under 40, roughly stable for those aged 40 to 49, and progressively larger from age 50 onwards, exceeding 5 percent per year in the oldest age groups for both sexes. In other words, the melanoma burden in Norway is increasingly concentrated in people over 60, who accounted for roughly 62 percent of male cases and 54 percent of female cases in the study.

The most revealing analytical technique in the study was age-period-cohort analysis, a statistical framework that separates the effects of growing older, of living through particular calendar eras, and of belonging to a particular birth generation. The results pointed firmly to a birth-cohort effect: successively more recent generations of Norwegians have carried progressively higher melanoma risk into older age, especially from age 60 onwards, while younger cohorts show comparatively low and stable or declining incidence before age 40. This pattern suggests that melanoma risk in Norway has changed systematically across generations, plausibly reflecting cumulative lifetime exposure to ultraviolet radiation that differs markedly between those who came of age before and after the boom in sunbathing, indoor tanning, and holidays in sunny destinations.

Ultraviolet radiation is classified as a Group 1 carcinogen by the International Agency for Research on Cancer, and it drives melanoma by inducing DNA damage and immunological alterations in the skin. Risk rises with the number of sunburns accumulated over a lifetime, with high-intensity intermittent sun exposure, and with the use of indoor tanning devices, particularly among younger adults and women. Norway’s population, predominantly fair-skinned and prone to sunburn, is especially vulnerable to intermittent recreational exposure patterns — a burst of intense sun on holiday or a summer weekend rather than steady daily exposure. Against that backdrop, the generational split in the new data reads like a behavioural fingerprint: older generations accumulated decades of unprotected exposure, while younger Norwegians appear to be moderating theirs.

One of the most surprising regional findings concerns northern Norway, the part of the country with the lowest ambient ultraviolet intensity. Despite that, the north saw the steepest relative increase in melanoma incidence of any region over the full study period, with an average annual increase of 4.6 percent in men and 3.1 percent in women, and among women the rise accelerated to 5.3 percent per year after 2006. The south-east, which has the highest ambient ultraviolet levels, still accounts for the largest absolute number of cases because of its much bigger population, but the trajectory in the north points to factors beyond local sunlight. The researchers note that previous work has linked increased air travel to rising melanoma incidence in Norway, consistent with the growth since the 1970s in holidays to high-ultraviolet destinations — intermittent, intense exposure that a fair-skinned population in a low-sunlight region is poorly adapted to absorb.

The anatomical distribution of tumours adds further behavioural clues. Among men, melanomas arose most often on the trunk, which accounted for nearly half of male cases, followed by the upper limbs and head and neck, and head and neck incidence rose particularly steeply — a pattern generally associated with chronic, cumulative sun exposure, including outdoor occupational activity. Among women, the lower limbs were the most common site, followed by the trunk and upper limbs, and the fastest increases were seen on the trunk and upper limbs, sites more often linked to intermittent exposure and, potentially, indoor tanning. The authors caution that these location-specific patterns are descriptive and cannot by themselves prove which behaviours drove them, but they align with known sex differences in sun-seeking and tanning habits.

Histological subtype told a similar story of divergence. Superficial spreading melanoma, the most common subtype in both sexes, increased markedly between 1984 and 2024, with an average annual rise of 4.1 percent in men and 3.1 percent in women, and the increase was concentrated in older age groups, reaching 6.0 percent per year among those aged 70 and above. Nodular melanoma, a more aggressive form, declined by 2.2 percent per year in people under 50 while rising among those over 70. Importantly, the authors argue that the overall rise in incidence cannot be dismissed as mere overdiagnosis: a recent nationwide Norwegian analysis found increasing incidence across virtually all tumour thickness categories, including thick melanomas, suggesting that more intensive detection of thin lesions alone does not explain the trend.

The Norwegian experience also contrasts instructively with Australia, which launched the world’s most comprehensive skin cancer prevention programme in the 1980s, combining mass-media campaigns such as SunSmart, school-based education, sunbed regulation, and early-detection initiatives. Australia has seen more modest increases with advancing age and a more pronounced decline in younger groups, differences the researchers suggest may reflect the timing, intensity, and reach of national prevention efforts. Norway’s prevention work, conducted since the 1990s mainly by the Norwegian Cancer Society and the Norwegian Radiation and Nuclear Safety Authority, has relied on public campaigns and guidance, but the evidence suggests it has not translated into sustained protective behaviour. In a large cohort of nearly 150,000 Norwegian women, sunscreen use rose between 1997 and 2007, yet the proportion reporting at least one sunburn per year increased from 39 to 46 percent over the same period. Norway’s 2017 ban on sunbed use for people under 18 was an important regulatory step, but early evaluations suggest limited behavioural impact so far.

The study’s authors conclude that Norway’s melanoma trends are compatible with a generational change in ultraviolet-related behaviour — stabilising rates in the young, continued increases among older cohorts, particularly men — and they call for targeted prevention aimed at the highest-risk groups and regions rather than awareness campaigns alone. Demographic shifts are unlikely to be driving the pattern, since immigrants from lower-risk regions remain a stable share of the population and people of European origin are still the largest immigrant group, leaving overall population susceptibility largely unchanged. The researchers also acknowledge the limits of their observational design: registry data cannot disentangle the individual contributions of sun exposure, tanning, travel, screening, and pathology practice, and rates in the youngest age groups rest on comparatively few cases. Still, with more than 60,000 diagnoses underpinning the analysis and registry completeness close to 99 percent, the message is difficult to ignore. The generational tide in melanoma may be turning for young Norwegians, but for their parents and grandparents the epidemic is still gathering force, and the steepest rises are happening where the sun shines least.

Subject of Research: Long-term trends in cutaneous melanoma incidence in Norway by age, sex, birth cohort, region, anatomical site, and subtype, 1980–2024

Article Title: Melanoma incidence in Norway, 1980–2024: a cohort study

Article References: Melanoma incidence in Norway, 1980–2024: a cohort study. (n.d.). https://doi.org/10.1016/j.lanepe.2026.101882

Image Credits: AI Generated

DOI: 10.1016/j.lanepe.2026.101882

Keywords: melanoma, Norway, ultraviolet radiation, birth cohort, cancer registry, skin cancer, epidemiology, indoor tanning, superficial spreading melanoma, age-period-cohort analysis, prevention, northern Norway