Update on the incidence and mortality from melanoma in the United States

Hall, H. Irene; Miller, Donald R.; Rogers, Joseph D.; Bewerse, Barbara A.

doi:10.1016/s0190-9622(99)70562-1

Cited by 237 publications

(176 citation statements)

References 21 publications

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“…For both sexes, the increases have been predominantly of thin, early-stage tumours, as has been the trend in other populations (Hall et al, 1999;Marrett et al, 2001;. Increases in thick tumours were seen mainly in the older age groups and similar trends have been observed elsewhere (Murray et al, 2005).…”

Section: Discussionsupporting

confidence: 75%

“…These trends compare well with those from other studies. Several authors reported a levelling off in incidence rates in the 1990s in the UK (Mackie et al, 1997(Mackie et al, , 2002Newnham and Moller, 2002) and other white Caucasian populations (Hall et al, 1999;Marrett et al, 2001;de Vries et al, 2003). Recent MM incidence rates for the UK, covering the period 1993 -2002, show similar trends, with relatively stable incidence rates between 1993 and 1999 but a sharp rise in incidence thereafter (Cancer Research UK, 2005).…”

Section: Discussionmentioning

confidence: 97%

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Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

2006

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The aim of this study was to investigate recent trends in incidence, mortality and survival in patients diagnosed with malignant melanoma (MM) in relation to stage (Breslow thickness). Cases of primary invasive and in situ MM diagnosed between 1st January 1993 and 31st December 2003 in the former Yorkshire Health Authority were identified from cancer registry data. Over the study period, the incidence of invasive MM increased from 5.4 to 9.7 per 100 000 in male subjects and from 7.5 to 13.1 per 100 000 in female subjects. Most of this increase was seen in thin tumours (o1.5 mm). Thin tumours were more likely to be diagnosed in the younger age groups and be classified as superficial spreading melanoma. In situ melanoma rates increased only slightly. Over the same time period, mortality rates have been relatively constant in both male and female subjects. Five-year relative survival varied from 91.8% (95% CI 90.4 -93.1) for patients with thin tumours to 41.5% (95% CI 36.7 -46.3) for those with thick tumours. In multivariable analyses, Breslow thickness was the most important prognostic factor. Age, sex and level of deprivation were also identified as independent prognostic factors. The trends in incidence suggest that the increase is real, rather than an artefact of increased scrutiny, implying that primary prevention in the Yorkshire area of the UK has failed to control trends in incidence. Mortality, in contrast, appears to be levelling off, indicating that secondary prevention has been more effective.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 97%

Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

2006

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“…Tumor borders were determined on serial sections, using Hoechst nuclear stains and hematoxylin and eosin stains. Morphometric analyses of lymphatic vessels and of blood vessels were performed in the peritumoral area using the IP-Lab software (Scanalytics, Fairfax, VA, USA) to determine the vessel number per mm 2 , that is, lymphatic vessel density (LVD), and the blood vessel density (BVD). The average vessel size (in mm 2 ) and the relative tissue area occupied by vessels, that is, the lymphatic vessel area (LVA; expressed as %) and the blood vessel area (BVA), were quantified as previously described.…”

Section: Computer-assisted Morphometric Analysismentioning

confidence: 99%

“…2 Melanoma is among the most common types of cancer in young adults, and death from melanoma occurs at a younger age than for any other common malignancy, 3 representing a substantial public health problem. The prognosis of patients with melanoma depends on the tumor stage at diagnosis, and is currently based on microstaging and clinical/radiologic evaluation for metastases.…”

mentioning

confidence: 99%

Tumor lymphangiogenesis predicts melanoma metastasis to sentinel lymph nodes

et al. 2005

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Cutaneous melanoma is a common melanocytic neoplasm that can quickly metastasize to regional lymph nodes. Currently, prognosis is determined by measuring tumor thickness but more reliable markers for metastatic spread are urgently needed. We investigated whether the extent of tumor lymphangiogenesis can predict melanoma metastasis to sentinel lymph nodes. We quantified the extent of tumor lymphangiogenesis, as well as other factors, in excised primary tumors and in sentinel lymph node biopsy samples from 45 patients with primary cutaneous melanoma. The results were correlated with histological and clinical outcome. Primary melanomas from patients whose tumors had metastasized to the sentinel lymph nodes contained prominent 'hot spots' of increased lymphatic vessel density, compared to nonmetastatic tumors. Multivariate risk analysis revealed that the lymphatic vascular area of primary melanomas, an index of tumor lymphangiogenesis, was the most sensitive prognostic marker for sentinel lymph node metastasis, and was even able to more accurately predict which tumors were metastatic to sentinel lymph nodes than the currently used method of measuring tumor thickness. Highly lymphangiogenic melanomas maintained their lymphangiogenic activity after metastasis to the sentinel lymph node. The extent of tumor lymphangiogenesis is a highly sensitive (83%) and specific (89%) prognostic marker of lymph node metastasis. Assessment of lymphangiogenesis in primary melanomas may be a more effective approach than the currently used technique of measuring tumor thickness in selecting patients with early metastatic disease for aggressive therapy. Keywords: LYVE-1; lymphangiogenesis; angiogenesis; sentinel lymph node; VEGF-C and VEGF-D In 2003, it was estimated that 7700 patients in the US would die from cutaneous melanoma, 1 a melanocytic tumor with increasing worldwide incidence and mortality rates. 2 Melanoma is among the most common types of cancer in young adults, and death from melanoma occurs at a younger age than for any other common malignancy, 3 representing a substantial public health problem. The prognosis of patients with melanoma depends on the tumor stage at diagnosis, and is currently based on microstaging and clinical/radiologic evaluation for metastases. In addition to a complete surgical excision with wide margins, patients with primary melanomas 41.0 mm thick undergo intraoperative lymphatic mapping and sentinel lymph node (SLN) biopsy to identify the first deposition of microscopic metastatic cells. 4 Among several prognostic parameters, tumor thickness is currently the most sensitive parameter for predicting the metastatic risk of cutaneous melanoma. However, the prognosis for individual melanoma patients is still difficult to determine, since thin melanomas can also develop into lethal metastases. 5 More accurate prognostic indicators for melanoma metastasis are therefore urgently needed.Recently, studies in mouse tumor models have shown that some types of malignant tumors actively induce the formation of lym...

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“…1 It has also become apparent more recently in several other North American populations: Canada, since the mid-1980s 4 and the U.S. areas in the SEER (Surveillance, Epidemiology and End Results) program since the early 1990s. 13 In these populations, increases have generally been greater in males than in females (or decreases greater in females than in males), so that the male to female incidence rate ratio has risen. In both North America and Australasia, there is good evidence that the secular trends are the result of cohort patterns, with more recently born cohorts at lower risk.…”

Section: International Trendsmentioning

confidence: 99%

Trends in the incidence of cutaneous malignant melanoma in New South Wales, 1983-1996

2001

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The incidence of cutaneous malignant melanoma (CMM) has been rising in fair-skinned populations throughout the world for decades. The upward trend may, however, finally be slowing in some of these populations. Recent (1983Recent ( -1996 CMM incidence trends for a high incidence area (New South Wales, Australia) have been examined according to gender, age group, body site and tumour thickness. Despite continuing upward trends in older age groups, particularly among men (e.g., 7.20% increase per year in men aged 75؉), incidence for younger ages is stabilizing (in men) or declining (in women): average annual percentage changes of ؊3.03 and ؊0.88 were observed for women aged 15-34 and 35-54, respectively. Patterns suggest a birth-cohort effect, with those born since 1945 or 1950 having lower (females) or similar (males) rates to those born earlier. For each gender, all-ages incidence rose by a similar amount for each of the main body sites except the leg in women, where incidence fell by 0.49% per year. In men, the incidence of both thin (<75 mm) and thick (>75 mm) melanomas increased (significantly, by 2.63% per year and non-significantly, by 0.93% per year, respectively) between 1989 and 1996. In women, incidence remained stable for both thickness subgroups. These data are consistent with a stabilization or reduction in either total sun exposure or intermittency of exposure among New South Wales cohorts born since about 1950. Because incidence rates are still much higher than they were a few decades ago, however, efforts to reduce sun exposure, particularly in children and youth, must continue. © 2001 Wiley-Liss, Inc. Key words: melanoma; trends; incidenceThe incidence of cutaneous malignant melanoma (CMM) has been rising in fair-skinned populations throughout the world for several decades. 1 However, incidence may finally have begun to stabilize or even to fall in younger people (and in recently born cohorts) in some of these populations. [2][3][4] As a result of the increasing incidence, CMM is now one of the more common cancers in white populations. It ranks 4th in men and 3rd in women in high incidence areas such as Australia 5 and New Zealand (non-Maoris) 6 and about 6th in medium incidence areas like the U.S. (whites), Scandinavia and parts of Canada. 6 Further, CMM has a predilection for youth: it is one of the most common cancers in those age 15-34 in many high (e.g., Australia) 6 and middle (e.g., Ontario, Canada) 7 incidence areas. Because of these features, high incidence areas in particular have made efforts to educate the public and health professions about "sun smart behavior" and early detection of melanoma.Monitoring trends in incidence of melanoma in a variety of settings is important to improve our understanding of its natural history, to monitor the possible effects of preventive or early detection strategies, to predict health service requirements, and to assist in setting and re-evaluating priorities within the health care system. This report presents a detailed analysis of the trends in melan...

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Update on the incidence and mortality from melanoma in the United States

Cited by 237 publications

References 21 publications

Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

Recent trends in cutaneous malignant melanoma in the Yorkshire region of England; incidence, mortality and survival in relation to stage of disease, 1993–2003

Tumor lymphangiogenesis predicts melanoma metastasis to sentinel lymph nodes

Trends in the incidence of cutaneous malignant melanoma in New South Wales, 1983-1996

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