MCC accounts for less than 1% of all skin cancers, with approximately 2500 cases detected annually in the US.[3]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Merkel cell carcinoma [internet publication].
https://www.nccn.org/guidelines/category_1
Incidence is increasing (postulated to be as a result of an aging population and improved recognition) and is projected to reach >5000 cases a year in the US by 2030.[4]Fitzgerald TL, Dennis S, Kachare SD, et al. Dramatic increase in the incidence and mortality from Merkel cell carcinoma in the United States. Am Surg. 2015 Aug;81(8):802-6.
http://www.ncbi.nlm.nih.gov/pubmed/26215243?tool=bestpractice.com
[5]Paulson KG, Park SY, Vandeven NA, et al. Merkel cell carcinoma: current US incidence and projected increases based on changing demographics. J Am Acad Dermatol. 2018 Mar;78(3):457-63.e2.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815902
http://www.ncbi.nlm.nih.gov/pubmed/29102486?tool=bestpractice.com
[6]Jacobs D, Huang H, Olino K, et al. Assessment of age, period, and birth cohort effects and trends in Merkel cell carcinoma incidence in the United States. JAMA Dermatol. 2021 Jan 1;157(1):59-65.
https://jamanetwork.com/journals/jamadermatology/fullarticle/2772469
http://www.ncbi.nlm.nih.gov/pubmed/33146688?tool=bestpractice.com
Based on available data, the highest recorded incidence of MCC globally is in Australia, where it is reported to be as high as 2.5 per 100,000 people, followed by New Zealand with 0.96 per 100,000, then the US with 0.7 cases per 100,000 people. In Europe, incidence ranges from 0.12 to 0.6 per 100,000 people.[5]Paulson KG, Park SY, Vandeven NA, et al. Merkel cell carcinoma: current US incidence and projected increases based on changing demographics. J Am Acad Dermatol. 2018 Mar;78(3):457-63.e2.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815902
http://www.ncbi.nlm.nih.gov/pubmed/29102486?tool=bestpractice.com
[6]Jacobs D, Huang H, Olino K, et al. Assessment of age, period, and birth cohort effects and trends in Merkel cell carcinoma incidence in the United States. JAMA Dermatol. 2021 Jan 1;157(1):59-65.
https://jamanetwork.com/journals/jamadermatology/fullarticle/2772469
http://www.ncbi.nlm.nih.gov/pubmed/33146688?tool=bestpractice.com
[7]Gauci ML, Aristei C, Becker JC, et al; the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC). Diagnosis and treatment of Merkel cell carcinoma: European consensus-based interdisciplinary guideline - update 2022. Eur J Cancer. 2022 Aug:171:203-31.
https://www.ejcancer.com/article/S0959-8049(22)00253-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35732101?tool=bestpractice.com
[8]Mistry K, Levell NJ, Hollestein L, et al. Trends in incidence, treatment and survival of Merkel cell carcinoma in England 2004-2018: a cohort study. Br J Dermatol. 2023 Feb 10;188(2):228-36.
http://www.ncbi.nlm.nih.gov/pubmed/36763882?tool=bestpractice.com
Incidence increases with age and is highest among those >85 years of age.[4]Fitzgerald TL, Dennis S, Kachare SD, et al. Dramatic increase in the incidence and mortality from Merkel cell carcinoma in the United States. Am Surg. 2015 Aug;81(8):802-6.
http://www.ncbi.nlm.nih.gov/pubmed/26215243?tool=bestpractice.com
[5]Paulson KG, Park SY, Vandeven NA, et al. Merkel cell carcinoma: current US incidence and projected increases based on changing demographics. J Am Acad Dermatol. 2018 Mar;78(3):457-63.e2.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815902
http://www.ncbi.nlm.nih.gov/pubmed/29102486?tool=bestpractice.com
The incidence of MCC is higher in men than in women, with various studies reporting that 61% to 66% of cases are in men.[1]Lemos BD, Storer BE, Iyer JG, et al. Pathologic nodal evaluation improves prognostic accuracy in Merkel cell carcinoma: analysis of 5823 cases as the basis of the first consensus staging system. J Am Acad Dermatol. 2010 Nov;63(5):751-61.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956767
http://www.ncbi.nlm.nih.gov/pubmed/20646783?tool=bestpractice.com
[4]Fitzgerald TL, Dennis S, Kachare SD, et al. Dramatic increase in the incidence and mortality from Merkel cell carcinoma in the United States. Am Surg. 2015 Aug;81(8):802-6.
http://www.ncbi.nlm.nih.gov/pubmed/26215243?tool=bestpractice.com
[5]Paulson KG, Park SY, Vandeven NA, et al. Merkel cell carcinoma: current US incidence and projected increases based on changing demographics. J Am Acad Dermatol. 2018 Mar;78(3):457-63.e2.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815902
http://www.ncbi.nlm.nih.gov/pubmed/29102486?tool=bestpractice.com
[9]Agelli M, Clegg LX. Epidemiology of primary Merkel cell carcinoma in the United States. J Am Acad Dermatol. 2003 Nov;49(5):832-41.
http://www.ncbi.nlm.nih.gov/pubmed/14576661?tool=bestpractice.com
[10]Harms KL, Healy MA, Nghiem P, et al. Analysis of prognostic factors from 9387 Merkel cell carcinoma cases forms the basis for the new 8th edition AJCC staging system. Ann Surg Oncol. 2016 Oct;23(11):3564-71.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881989
http://www.ncbi.nlm.nih.gov/pubmed/27198511?tool=bestpractice.com
MCC is predominantly seen in white patients and is very rare in people of color.[7]Gauci ML, Aristei C, Becker JC, et al; the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC). Diagnosis and treatment of Merkel cell carcinoma: European consensus-based interdisciplinary guideline - update 2022. Eur J Cancer. 2022 Aug:171:203-31.
https://www.ejcancer.com/article/S0959-8049(22)00253-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/35732101?tool=bestpractice.com
There is an 8-fold increased incidence in white individuals compared with non-Hispanic black people.[11]Freeman MB, Holman DM, Qin J, et al. Merkel cell carcinoma incidence, trends, and survival rates among adults aged ≥50 years from United States Cancer Statistics. J Am Acad Dermatol. 2019 Apr;80(4):1154-6.
https://www.jaad.org/article/S0190-9622(18)32815-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/30876535?tool=bestpractice.com
An estimated 80% of MCC tumors in North America occur in people who are positive for Merkel cell polyomavirus (MCPyV), whereas in Australia, only 24% of MCCs are estimated to be MCPyV-associated.[12]Garneski KM, Warcola AH, Feng Q, et al. Merkel cell polyomavirus is more frequently present in North American than Australian Merkel cell carcinoma tumors. J Invest Dermatol. 2009 Jan;129(1):246-8.
https://www.jidonline.org/article/S0022-202X(15)34058-6/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/18650846?tool=bestpractice.com
Australia has the highest reported prevalence of ultraviolet light-associated MCC tumors.[13]Stang A, Becker JC, Nghiem P, et al. The association between geographic location and incidence of Merkel cell carcinoma in comparison to melanoma: an international assessment. Eur J Cancer. 2018 May;94:47-60.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019703
http://www.ncbi.nlm.nih.gov/pubmed/29533867?tool=bestpractice.com