Poor prognosis for malignant melanoma in Northern Ireland: a multivariate analysis

Gordon, Louisa G.; Lowry, W. S.; Pedlow, P. J.; Patterson, C. C.

doi:10.1038/bjc.1991.66

Cited by 8 publications

(6 citation statements)

References 11 publications

(10 reference statements)

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“…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.…”

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confidence: 73%

Cutaneous malignant melanoma in Northern Ireland

Pedlow

Walsh²,

Patterson³

et al. 1997

Br J Cancer

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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...

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Cutaneous malignant melanoma in Northern Ireland

Pedlow

Walsh²,

Patterson³

et al. 1997

Br J Cancer

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“…b Range = interquartile range. c Relative survival: national (not regional) data based on Eurocare III (cases diagnosed between 1990-1994) are given (Berrino et al, 2003), except for Northern Ireland (Gordon et al, 1991). (16) 29 (25) 29 (25) 11 (9) 28 (24) 21 (18) 23 (20) 2 (2) 18 (16) 52 (45) 13 (11) 16 (14) 27 (23) 32 (28) 4 (3) 24 (21) (20) 55 (19) 18 (6) 64 (22) 15 (5) 173 (60) 6 (2) 36 (12) 59 (20) 21 (7) 82 (28) 27 (9) 134 (46) (26) 84 (40) 22 (11) 5 (2) 43 (21) 28 (13) 128 (62) (14) 67 (20) 143 (42) 23 (7) 58 (17) 57 (17) 159 (47) 24 (7) 11 (3) 89 (26) 55 (16) 43 (13) 68 (20) In the period 1995-2000, cases with a T4 melanoma at diagnosis were older than cases with other known stages (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…We also compared our incidence data with corresponding survival statistics derived from published data on the registries/countries concerned (Gordon et al, 1991;Berrino et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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

Vries

Bray

Eggermont

et al. 2004

European Journal of Cancer Prevention

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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.

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“…Delays in the diagnosis of MM have been correlated with increased tumor thickness 4 and have been found to contribute to poor overall survival for cutaneous MM. 5 These delays may be caused by either a patient's hesitation to seek medical attention or may be a result of physician misdiagnosis.…”

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confidence: 99%