Trends in the survival of patients diagnosed with malignant melanoma of the skin in the Nordic countries 1964–2003 followed up to the end of 2006

Abstract A previous Nordic study showed a marked and steady increase in the age-adjusted 5-year relative survival of skin melanoma patients diagnosed during the period 1958 through 1987. Males had considerably poorer survival than females. Material and methods. Using the NORDCAN database, we studied relative survival and excess mortality of patients diagnosed with melanoma of the skin in the Nordic countries 1964–2003 followed up to the end of 2006. These were contrasted with concomitant trends in incidence and mortality. Results. The overall incidence of melanoma almost quadrupled, but there was considerable variation in the trends in the five countries. Mortality was low but doubled during the study period. Survival ratios increased steadily to between 80% and 90% for patients diagnosed in 1999–2003. Swedish patients had consistently higher survival, whereas Danish patients had the highest excess death rates the first three months after diagnosis up until 1990, but thereafter, rates reached a similar low level to that observed in the other Nordic countries. The survival of Nordic women is still higher than that of men, but the difference has diminished, while the mortality rates among men are becoming increasingly higher relative to those for women among individuals 50 years and older. In younger individuals, mortality rates are similar in the two sexes, and declining. Conclusions. Nordic patient survival following melanoma diagnosis is generally high and has been steadily increasing in the last decades. Differences in incidence between the five countries are more pronounced than the differences in survival. The strong upward trends in incidence and survival may mainly be the result of extensive changes in sunbathing habits or other UV exposure and, more recently, of an increasing awareness by the medical community and the public concerning early detection of melanoma of the skin.

[1]  L. Tryggvadottir,et al.  A melanoma epidemic in Iceland: possible influence of sunbed use. , 2010, American journal of epidemiology.

[2]  F. Bray,et al.  Trends in the survival of patients diagnosed with cancer in the Nordic countries 1964–2003 followed up to the end of 2006. Material and methods , 2010, Acta oncologica.

[3]  Arnold Knijn,et al.  EUROCARE-4. Survival of cancer patients diagnosed in 1995-1999. Results and commentary. , 2009, European journal of cancer.

[4]  H. Storm,et al.  Social inequality and incidence of and survival from malignant melanoma in a population-based study in Denmark, 1994-2003. , 2008, European journal of cancer.

[5]  A. Hauschild,et al.  Cutaneous malignant melanoma: ESMO clinical recommendations for diagnosis, treatment and follow-up. , 2008, Annals of oncology : official journal of the European Society for Medical Oncology.

[6]  W. Anderson,et al.  Cancer survival statistics should be viewed with caution. , 2007, The Lancet. Oncology.

[7]  J. Ferlay,et al.  Cancer survival statistics should be viewed with caution. , 2007, The Lancet. Oncology.

[8]  C. Garbe,et al.  Diagnosis and treatment of cutaneous melanoma: state of the art 2006. , 2007, Melanoma research.

[9]  C. Garbe,et al.  Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976–2001 , 2007, Cancer.

[10]  S. Gruber,et al.  Cutaneous and Ocular Melanoma , 2006 .

[11]  J. Fraumeni,et al.  Cancer epidemiology and prevention. , 2006 .

[12]  S. Ariyan,et al.  Gender-Related Differences in Outcome for Melanoma Patients , 2006, Annals of surgery.

[13]  C. Ingvar,et al.  Invasive cutaneous malignant melanoma in Sweden, 1990–1999 , 2004, Cancer.

[14]  Mike Quinn,et al.  Standard cancer patient population for age standardising survival ratios. , 2004, European journal of cancer.

[15]  F Berrino,et al.  EUROCARE-3: survival of cancer patients diagnosed 1990-94--results and commentary. , 2003, Annals of oncology : official journal of the European Society for Medical Oncology.

[16]  P. Boyle,et al.  Mortality from cutaneous melanoma: evidence for contrasting trends between populations , 2000, British Journal of Cancer.

[17]  K. Boo-Chai,et al.  Prognostic trees to aid prognosis in patients with cutaneous malignant melanoma. , 1998 .

[18]  G. Giles,et al.  Has mortality from melanoma stopped rising in Australia? Analysis of trends between 1931 and 1994 , 1996, BMJ.

[19]  T. Ovesen Implications of middle ear hyperoxia induced by ventilation tubes in otitis media with effusion , 1995, APMIS. Supplementum.

[20]  R. MacKie,et al.  Audit of public education campaign to encourage earlier detection of malignant melanoma. , 1992, BMJ.

[21]  M. Aapro,et al.  Report on consensus meeting of the EORTC melanoma group of educational needs for primary and secondary prevention of melanoma in Europe , 1991 .

[22]  U. Ringborg,et al.  Early detection and prevention of cutaneous malignant melanoma: Emphasis on Swedish activities , 1991, Medical oncology and tumor pharmacotherapy.

[23]  S J Soong,et al.  Changing trends in cutaneous melanoma over a quarter century in Alabama, USA, and New South Wales, Australia , 1983, Cancer.

[24]  J. Knowelden,et al.  Cancer Epidemiology and Prevention , 1976, British Journal of Cancer.

[25]  M. Janssen-Heijnen,et al.  Superior survival of females among 10,538 Dutch melanoma patients is independent of Breslow thickness, histologic type and tumor site. , 2008, Annals of oncology : official journal of the European Society for Medical Oncology.

[26]  A. Engeland,et al.  Prediction of cancer mortality in the Nordic countries up to the years 2000 and 2010, on the basis of relative survival analysis. A collaborative study of the five Nordic Cancer Registries. , 1995, APMIS. Supplementum.

[27]  D. Driscoll,et al.  Prognostic parameters in localised melanoma: gender versus anatomical location. , 1995, European journal of cancer.

[28]  M. Aapro,et al.  Report on consensus meeting of the EORTC Melanoma Group on educational needs for primary and secondary prevention of melanoma in Europe. Results of a workshop held under the auspices of the EEC Europe against cancer programme in Innsbruck, April 1991. , 1991, European journal of cancer.

[29]  E. Somers International Agency for Research on Cancer. , 1985, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[30]  G. Cage,et al.  Precursors to malignant melanoma. National Institutes of Health Consensus Development Conference Statement, Oct. 24-26, 1983. , 1984, Journal of the American Academy of Dermatology.