Incidence rates of melanoma are expected to continue rising. These trends are worrying in terms of disease burden, particularly in eastern European countries.

Melanoma can be considered an emerging chronic disease that may considerably affect patients’ lives. The authors systematically reviewed the available literature on health-related quality of life (HRQOL) and melanoma. Of reviews and the selected studies, reference lists were hand-searched. The quality of the eligible studies was appraised based on 14 previously published criteria. Of the 158 abstracts, 44 articles were appraised, resulting in 13 selected studies written in English (published between 2001 and 2008). Most studies assessed patients from specialised centres with varying, but relatively advanced, disease stages. The most commonly used instruments were the SF-36 and EORTC QLQ-C30. Recently, a melanoma-specific HRQOL questionnaire [FACT-Melanoma (FACT-M)] was introduced for clinical trial purposes. It showed that approximately one-third of melanoma patients experienced considerable levels of distress, mostly at the time of diagnosis and following treatment. Systemic therapies affected HRQOL negatively in the short term, but to a lesser extent in the long term. Health status and patients’ psychological characteristics are associated with higher levels of HRQOL impairment. The authors found that the impact of melanoma on patients’ HRQOL is comparable to that of other cancers. Accurately assessing HRQOL impairment in melanoma patients is pivotal, as it may affect disease management, including therapy and additional counselling, future preventive behaviour and perhaps even prognosis.

Epidemiology of rare cutaneous malignancies in the general population is poorly documented. This descriptive study aimed to estimate the incidence and trends of all skin malignancies between 1989 and 2005. Data on skin tumors were extracted from the Netherlands Cancer registry (except for basal cell carcinoma (BCC) data-only available from Comprehensive Cancer Centre South) and categorized according to the International Classification of Diseases for Oncology, third edition, codes. Age-standardized incidence rates (European standardized population rate, ESR) per 100,000 person-years were calculated per year and for the period between 2001 and 2005. Estimated annual percentage changes (EAPCs) were estimated by Poisson regression models. A total of 356,620 skin tumors were diagnosed between 1989 and 2005. Excluding BCC, squamous cell carcinoma (SCC), and melanoma, the remaining skin tumors constituted about 2% of all skin malignancies. The incidence of melanoma showed the steepest increase (EAPC, 4.0%), and ESR was close to that observed for SCC (EAPC, 2.3%) between 2001 and 2005 (17.1 versus 19.6). Hematolymphoid tumors (ESR=0.74) were mainly cutaneous T-cell lymphomas (60.8%). No significant increases in incidence were observed for lymphomas, and appendageal, fibromatous, and myomatous carcinomas during 1989-2005. In addition to keratinocytic cancers and melanoma, there is a wide variety of skin tumors that constitute <2% of all skin malignancies. The incidence of UV-related skin tumors increased significantly and more steeply than did those of other skin malignancies.

To assess the impact of melanoma on the health-related quality of life of patients from the general population up to 10 years after diagnosis and its determinants.Design: A cross-sectional Dutch population-based postal survey among patients with melanoma for the years 1998 to 2008 using the Eindhoven Cancer Registry. Main Outcome Measures:The 36-Item Short-Form Health Survey (SF-36), Impact of Cancer (IOC) questionnaire and specific melanoma-related questions. The SF-36 scores of the cases were compared with normative data. Multiple linear regression models were used to identify associated factors of SF-36 and IOC scores.Results: The response rate was 80%. The mean age of the 562 respondents was 57.3 years; 62% were female, and 76% had a melanoma with a Breslow thickness of less than 2 mm. The SF-36 component scores of pa-tients with melanoma were similar to those of the normative population. In a multiple linear regression model, stage at diagnosis, female sex, age, and comorbidity were significantly associated (PϽ .05) with the physical and mental component scores. Women were significantly more likely to report higher levels of both positive and negative IOC. Time since diagnosis, tumor stage, and comorbidity were significant predictors of negative IOC scores. Women seemed to adjust their sun behavior more often (54% vs 67%; P Ͻ.001) than men and were more worried about the deleterious effects of UV radiation (45% vs 66%; PϽ .001). Conclusion:The impact of melanoma seems to be specific and more substantial in women, suggesting that they may need additional care to cope with their melanoma optimally.

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Follow-up frequency was higher than recommended by the current melanoma guideline in a large group of patients, mainly those with lower Breslow thickness.

Melanoma is becoming a great burden to Dutch society.