Monitoring stage-specific trends in melanoma incidence across Europe reveals the need for more complete information on diagnostic characteristics

Abstract

Cutaneous malignant melanoma has been characterized by rapid and steady increases in incidence and mortality in white populations. Some reports mentioned declining trends in the mean thickness of these tumours, but other studies suggested a stable incidence of thick melanomas. The aim of this study was to describe the stage distribution of melanomas across Europe, with particular reference to temporal trends. Twenty-three cancer registries provided data sets containing information on stage and histology, 21 of which were used for a general description and nine for trends analyses. Despite a preponderance of missing data, interesting patterns emerged: a less favourable stage distribution in populations with relatively low incidence, but high case-fatality rates, and a favourable trend in stage and histology distribution over time, including a shift from later to earlier stages in recent years. Early detection campaigns raising awareness for thin lesions can potentially improve melanoma survival rates. Monitoring of stage-specific trends in melanoma incidence can assess the impact of such interventions. This paper demonstrates the potential utility of high-quality, timely cancer registry data in pursuing such public health objectives and addresses the need for more complete information on diagnostic features of melanoma patients. This will allow more informative evaluations of preventive strategies.

Epidemiology of Melanoma

“…Like with melanoma incidence, among fair-skinned populations, melanoma mortality rate is highest in low-latitude regions (Figures 3 and 4) (9). In high-risk regions like New Zealand, Australia, North America, and Europe, mortality rates historically increased until the 1980s (97,98), peaked between 1988 and 1990, and then gradually maintained a slow increase (19,32,56,68,96,99,100). Over the last decade, mortality rate has steadily increased at 1.5% in the highest observed countries of New Zealand and Australia (19).…”

Stage distribution of malignant melanomas in a Hungarian centre

“…A nyugati országokhoz viszonyított kedvezőtlen stá-diummegoszlást alátámasztja De Vries és munkatársai tanulmánya, amely során 23 európai rákregiszterben tekintették át az újonnan diagnosztizált melanomák stá-diumait [19]. A tanulmány alapján a kelet-közép-európai országokban Észak-és Nyugat-Európához képest az alacsonyabb incidenciához hátrányosabb stádium szerinti megoszlás és magasabb mortalitás társul.…”

“…Már szó volt róla, hogy míg Ausztráliában és NyugatEurópában már az 1980-as évek óta szerveznek bőrda-ganatokkal kapcsolatos felvilágosító kampányokat [19], Kelet-Közép-Európa számos országában csak az utóbbi években indultak el ezek a kezdeményezések [21]. Bár ezek a kezdeményezések biztatóak, a nyugati országoknál kedvezőtlenebb stádiummegoszlás megszün-tetése érdekében számos egyéb lépés mellett további széles körű szűrő-oktató programokra lenne szükség.…”

Screening, early detection, and trends for melanoma: Current status (2000-2006) and future directions

“…The most frequent body sites for melanoma include the trunk, head, and neck in men and the legs in females. 7 De Vries et al 8,9 analyzed 211,557 incident cases of melanoma recorded during from 1953 to 1998 from 63 European cancer registries. Incidence rates vary significantly depending on the geographic location, with higher rates in northern European countries (such as Norway and Sweden) and lower rates in southern and eastern Europe (such as Poland and Italy).…”