Eyelid malignancies on the rise? A population-based analysis of merkel cell carcinoma, melanoma, and sebaceous carcinoma from the SEER database

Purpose: This study sought to analyze temporal incidence trends for malignant melanoma (MM), Merkel cell carcinoma (MCC), and sebaceous gland carcinoma (SGC) of the eyelid and to predict future patterns using population-based data. Methods: A retrospective analysis was conducted using the Surveillance, Epidemiology,and End Results (SEER) database from 2000-2021. Time-series models, including Autoregressive Integrated Moving Average (ARIMA) and Neural Network Autoregression (NNAR), were applied to estimate incidence rates (IRs) per 100,000, stratified by tumor type, sex, age, and race. Model selection was based on minimizing Root Mean Square Error (RMSE). Poisson regression was used to assess the impact of age and sex on IRs. Results: The overall IR for these malignancies showed an increase from 2000 to 2015,followed by a slight decline and a subsequent rise in 2021; a 10-year forecast projects a continued modest increase. Subtype analysis revealed variable trends: MM incidence is projected to rise, while MCC and SGC incidence rates are forecasted to remain relatively stable. Poisson regression identified age >60 years as a highly significant risk factor, dramatically increasing the incidence rate ratio (IRR) for both MM (IRR 17.1) and SGC (IRR 25.4). Gender was not a significant factor. Racial disparities were evident; White individuals had the highest incidence of MM, whereas Asian or Pacific Islander individuals had the highest incidence of SGC. Conclusion: Malignant eyelid tumors exhibit distinct patterns. MCC has the highest metastatic risk, sebaceous adenocarcinoma varies by race, and surgery remains key