BACKGROUND: Melanoma incidence often shows an increasing latitudinal gradient from north to south among white European populations. OBJECTIVE: To assess emerging regional melanoma incidence patterns in the English population. METHODS: All primary invasive cutaneous melanomas diagnosed in England in people aged 10-89 years, 1996-2006, were ascertained. Age-standardized incidence rates by sex, age and Government Office Region were calculated for the entire population and for White Caucasians only. Rates according to socio-economic deprivation were further calculated among those under age 30. Regional heterogeneity and latitude and deprivation trends were assessed by Poisson regression and tests for trend. RESULTS: Overall, melanoma incidence in England was highest in the South West (all, 18.75; white, 19.03 per 100 000) and lowest in London (all, 8.85; white, 11.22 per 100 000). Incidence significantly increased with more southerly latitudes in all white adults over age 30 (p<0.0001) except females 30-49 years (1.8%, p=0.10). These north-south latitude trends were reversed in white 10-29 year olds however, with sex-specific analyses showing an absence of trend in males (2.7%, p=0.41) and a strong decreasing north-south latitude trend (-9.8%, p<0.0001) in females. Highest rates in young females occurred in the North West (5.46 per 100 000), and specifically in the second most deprived (5.69 per 100 000) and the second most affluent (6.48 per 100 000) groups. CONCLUSIONS: Melanoma incidence is high in young people in northern England including among the moderately deprived, reversing the expected north-south incidence gradients. Prevalent sunbed use in northern England and holiday sun exposure abroad may explain these emerging trends. This article is protected by copyright. All rights reserved.