Merkel Cell Carcinoma Epidemiology

Key Highlights

• DelveInsight's analysis projects that in 2023, there were approximately 5.8 thousand incident cases of MCC in the EU4 and the UK. This number is expected to grow at a compound annual growth rate (CAGR) of 4%, reaching a significant value by 2034.
• The increase in MCC cases is anticipated due to an advancements in diagnostic techniques, and greater awareness, resulting in earlier identification and a higher number of reported cases in 7MM.
• In 2023, the US had nearly 3.5 thousand total incident cases of MCC, with cases projected to grow at a 5% CAGR by 2034.
• In 2023, Germany reported approximately 900 cases of MCC in males and 700 cases in female of MCC.
• In 2023, EU4 and the UK recorded around 3.3 thousand cases of total metastatic cases (de novo + recurrent).
• In 2023, in Japan, approximately 42% of MCC cases were categorized as Stage I, 13% as Stage II, 37% as Stage III, and 8% as Stage IV. These stage-specific patterns are expected to continue, with the incidence anticipated to increase by 2034.

DelveInsight’s “MCC – Epidemiology Forecast – 2034” report delivers an in-depth understanding of MCC, historical and forecasted epidemiology of MCC in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.

Geography Covered

• The United States
• EU4 (Germany, France, Italy, and Spain) and the United Kingdom
• Japan

Study Period: 2021-2034

Merkel Cell Carcinoma (MCC) Disease Understanding 

Merkel Cell Carcinoma (MCC) Overview

MCC is a rare, aggressive neuroendocrine skin cancer that originates from Merkel cells. These specialized mechanoreceptors, located at the dermo-epidermal junction where the dermis and epidermis meet, play a key role in touch sensation and are closely linked to skin nerve endings. MCC is highly malignant, with rapid growth and a tendency for early metastasis, making it one of the deadliest skin cancers despite its rarity. Its cellular origin emphasizes the dual importance of Merkel cells in sensory function and the study of cancer biology. 

MCC is categorized into two types depending on the involvement of Merkel cell polyomavirus (MCPyV). Virus-positive MCC arises when the virus integrates its DNA into the host genome, leading to the production of oncoproteins that drive tumour development. These tumours usually exhibit fewer genetic mutations but elicit a stronger immune response, often making them more responsive to immunotherapy. In contrast, virus-negative MCC is primarily caused by UV-induced DNA damage. This type is characterized by a higher mutational burden and tends to be more aggressive, with a poorer immune response and reduced sensitivity to immune-based treatments.

Sun exposure is a significant risk factor for MCC, often occurring in sun-exposed areas. It predominantly affects older adults and immunocompromised individuals, like organ transplant recipients or those with CLL or HIV. Virus-negative MCC, typically found on the head or trunk, has more mutations and a poorer prognosis.

MCC is a rare, aggressive skin cancer often mistaken for other lesions or tumours due to its small, blue, round cell appearance. It can be confused with benign conditions such as cysts and dermatofibromas, or malignancies like amelanotic melanoma, lymphoma, small-cell carcinoma, and adnexal tumours. Immunohistochemistry, using markers like CK20 and neuroendocrine proteins, is essential for accurate diagnosis. MCC typically appears as a firm, painless nodule in sun-exposed areas, often accompanied by regional lymphadenopathy. Diagnosis involves biopsy, histopathological examination, imaging, and molecular tests, with the detection of MCPyV being particularly important.

Further details related to diagnosis are provided in the report…

Merkel Cell Carcinoma (MCC) Epidemiology

For the purpose of designing the patient-based model for MCC, the report provides historical as well as forecasted epidemiology segmented by Total Incident Cases of MCC, Gender-specific Incident Cases of MCC, Stage-specific Incident Cases of MCC, Etiology-specific Incident Cases of MCC, and Total Metastatic Cases of MCC in the 7MM covering the United States, EU4 countries (Germany, France, Italy, and Spain), the United Kingdom, and Japan, from 2021 to 2034. 

• DelveInsight's epidemiology model estimates that in 2023, there were approximately 9.5 thousand total incident cases of MCC across the 7MM which are expected to increase by 2034.
• In 2023, the US reported the highest number of total incident cases of MCC among the 7MM, with approximately 3.5 thousand, a figure expected to rise by 2034.
• In 2023, males accounted for 38% of MCC cases in Japan, while females represented 62%. These gender-specific patterns are expected to grow, with overall incidence projected to increase by 2034.
• In 2023, the UK reported nearly 560 cases of Stage I MCC, 170 cases of Stage II, 490 cases of Stage III, and 110 cases of Stage IV MCC. These numbers are expected to rise by 2034.
• In Japan, around 70% of MCC cases reported in 2023 were associated with MCPyV, while 30% were linked to UV damage, indicating that MCPyV is the primary causative factor.
• In 2023, Germany recorded around 980 cases of total metastatic cases (de novo + recurrent).
• In Spain, around 80% of MCC cases in 2023 were attributed to MCPyV, while 20% were linked to UV damage.
• In 2023, France reported around 1.4 thousand total incident cases of MCC and these numbers are expected to increase by 2034.
• In 2023, Italy reported approximately 450 incident cases of MCC in males and 340 cases in females, with numbers projected to rise by 2034.

KOL Views

To gaze into the epidemiology insights of the real world, we take KOLs and SMEs’ opinions working in the domain through primary research to fill the data gaps and validate our secondary research on disease incidence. 

DelveInsight’s analysts connected with 20+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. Centers such as the Johns Hopkins University, the US, Columbia University Irving Medical Center, the US, National Cancer Institute, the US, University of Duisburg-Essen, Germany, University of Montpellier, France, University of L’Aquila, Italy, Universidad de Málaga, Spain, the University of Manchester, the UK, Saga University, Japan, among others were contacted. Their opinion helps understand and validate current disease incidence, gender involved with the disease, diagnosis rate, and diagnostic criteria.

As per the KOLs from the US, MCC is a rare but aggressive form of skin cancer that arises when Merkel cells, specialized cells located deep within the epidermis, begin to grow uncontrollably. Normally, these cells remain stable and play a role in our sensory functions. However, in rare instances, they undergo abnormal growth, leading to the development of MCC.

As per the KOLs from the Germany, the risk factors for MCC include older age, immunosuppression, pre-existing blood cancers, chronic UV exposure, and a history of other skin tumors. MCC can develop through two main mechanisms: virus-associated etiology, where the MCPyV integrates into the cells, and virus-negative etiology, which is driven by UV-induced DNA mutations and damage. Both pathways highlight the importance of understanding the underlying causes to improve prevention and treatment strategies.

As per the KOLs from Japan, the discovery of MCPyV has significantly advanced our understanding of MCC pathogenesis. Following MCPyV infection and genome integration into MCC cells, these tumor cells undergo clonal expansion. This suggests that MCPyV acts as a pathogen, not just a passenger virus, playing a key role in MCC development.

Scope of the Report

• The report covers a segment of key events, an executive summary, a descriptive overview of MCC, explaining its causes, signs and symptoms, and currently available diagnostic algorithms and guidelines.
• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of diagnosis rate, disease progression, and diagnosis guidelines.
• The report provides an edge for understanding trends, expert insights/KOL views, and patient journeys in the 7MM.
• A detailed review of current challenges in establishing the diagnosis.

Merkel Cell Carcinoma (MCC) Report Insights

Patient Population

• Country-wise Epidemiology Distribution
• Total Incident Cases of MCC 
• Gender-specific Incident Cases of MCC 
• Stage-specific Incident Cases of MCC 
• Etiology-specific Incident Cases of MCC 
• Total Metastatic Cases of MCC

Merkel Cell Carcinoma (MCC) Report Key Strengths

• 10 years Forecast
• The 7MM Coverage 
• MCC Epidemiology Segmentation 
• Merkel Cell Carcinoma (MCC) Report Assessment
• Current Diagnostic Practices Patient Segmentation

Epidemiology Insights

• What are the disease risks, burdens, and unmet needs of MCC? What will be the growth opportunities across the 7MM concerning the patient population of MCC?
• What is the historical and forecasted MCC patient pool in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan?
• Why are the total cases of MCC in Japan lower than in the US?
• Which country has a high patient share for MCC?

Reasons to Buy

• Insights on patient burden/disease, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To understand the MCC cases in varying geographies over the coming years.
• To understand the perspective of key opinion leaders around the current challenges with establishing the diagnosis options.
• Detailed insights on various factors hampering disease diagnosis and other existing diagnostic challenges. 

Frequently Asked Questions

1. What is the forecast period covered in the report?

The MCC Epidemiology report for the 7MM covers the forecast period from 2025 to 2034, providing a projection of epidemiology dynamics and trends during this timeframe.

2. Out of all EU4 countries and the UK, which country had the highest population of MCC cases in 2023?

The highest cases of MCC were found in Germany among EU4 and the UK in 2023.

3. How is epidemiological data collected and analyzed for forecasting purposes?

Epidemiological data is collected through surveys, clinical studies, health records, and other sources. It is then analyzed to calculate disease rates, identify trends, and project future disease burdens using mathematical models.

4. Out of all 7MM countries, which country had the highest population of MCC cases in 2023?

The highest cases of MCC were found in the US among the 7MM in 2023.