Cutaneous malignant melanoma in Northern Ireland

Abstract

Summary The results of two 5-year studies, for 1974-78 and 1984-88, of cutaneous malignant melanoma (CMM) in Northern Ireland show changes in the presentation of the disease. Although there is some evidence of earlier diagnosis, the rise in incidence has produced an overall increase in the number of cases with advanced disease.Keywords: cutaneous malignant melanoma; epidemiology; histopathology As the incidence of melanoma continues to rise worldwide, the importance of early diagnosis is underlined. Collection of complete and accurate data is essential to the study of changes in presentation. A baseline study in Northern Ireland looked at all histopathologically confirmed cases of invasive cutaneous malignant melanoma (CMM) occurring during the 5-year period 1974-78 (Gordon and Lowry, 1986a). The majority of these presented with thick, advanced melanomas. The follow-up study confirmed a low 5-year survival rate of 54% (Gordon et al, 1991). The present study repeats the first study as closely as possible for 1984-88. The clinical and pathological presentation of cases for 1984-88 are reported and changes in the pattern of CMM are identified. MATERIALS AND METHODSNorthern Ireland lies between latitudes 54 and 56 degrees north. It has a maritime climate with a daily mean of 3.6 h of sunshine. The population was relatively stable at just over 1.5 million during the study period.Comprehensive lists of all histopathologically confirmed melanomas were obtained from the pathology departments in Northern Ireland, giving a total of 774 cases. For both studies, it is considered that very few cases of melanoma would escape histopathological confirmation in the province. RESULTSThere were 240 cases of invasive CMM for 1974-78 (62 men and 178 women) and 487 for 1984-88 (154 men and 333 women). Between the two periods, a significant increase (P < 0.05) in agestandardized incidence is observed from 3.18 to 6.09 per 100 000 population (men 1.68-3.91, women 4.64-8.19). The female-male ratio has fallen from 2.8: 1 to 2.1:1. Age Melanoma incidence increases with age (Figure 1), and incidence rates have increased across all age groups between the studies. SiteThere is no significant change in overall site distribution between the studies. Between the sexes, however, there are significant difference in site distribution both for 1974-78 (P < 0.005) and for 1984-88 (P < 0.0001), with the head/neck remaining the most common site for men and the leg for women (Table 1). The increase in numbers is greatest for the female leg and the male trunk. The 1984-88 study notes differences in distribution between the sexes for melanomas at subsites on the limbs (excluding the foot). On the upper limb, the forearm-upper arm ratio of lesions is 1.2:1 for women whereas for men the ratio is 3: 1. In contrast, melanomas on the leg in men are divided equally between the thigh and lower leg, while for women melanomas are five times more common on the lower than the upper leg.Tumour type There has been a significant change in tumour type distribution be...

Distribution of clinical‐pathological types of cutaneous melanomas and mortality rate in the region of Passo Fundo, RS, Brazil

“…The mean age of the study patients was 51.7 years, which agrees with the data from the literature 36,37,48,58,70 . In the sample studied, there is a predominance of cases in females, which agrees with the data found in the literature of various countries, such as Scotland, Spain, Brazil, 1,36,37,41,42,44,50,52,54,60,69,71,72 although in the literature there are a few variations on the result presented 44,48,58,70,73 . A greater number of lesions was also found in the 41–60‐year age group, which agrees with the literature 38,39,41,48,53,60,69,70 …”

Improved survival for melanoma in Northern Ireland: a comparison of two 5-year periods (1984-88 and 1994-98)

“…In the 1970s in Northern Ireland overall survival was very poor, in fact, it was among the worst reported at that time in the literature 5 . This was thought to be due to a very high proportion of advanced melanomas.…”

“…The incidence of melanoma in Northern Ireland (population 1·6 million) doubled between the 1974–88 and 1984–88 periods when the last analysis was performed, showing an overall rise in incidence from 3·2 per 100 000 population to 6·1 per 100 000 population in the later period 5 . Using data held in the Northern Ireland Cancer Registry, we performed a further analysis of melanoma in Northern Ireland to compare the 1984–88 and 1994–98 periods and we report on the incidence, survival, and the patterns and trends in the anatomical and pathological characteristics of patients.…”