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

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.

[1]  E. de Vries,et al.  Lower incidence rates but thicker melanomas in Eastern Europe before 1992: a comparison with Western Europe. , 2004, European journal of cancer.

[2]  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.

[3]  C. Luke,et al.  A critical analysis of reasons for improved survival from invasive cutaneous melanoma , 2003, Cancer Causes & Control.

[4]  F. Bray,et al.  Changing epidemiology of malignant cutaneous melanoma in Europe 1953–1997: Rising trends in incidence and mortality but recent stabilizations in Western Europe and decreases in Scandinavia , 2003, International journal of cancer.

[5]  P. Carli,et al.  Unexpected reduction of mortality rates from melanoma in males living in central Italy. , 2003, European journal of cancer.

[6]  P. Carli,et al.  Changes from mid-1980s to late 1990s among clinical and demographic correlates of melanoma thickness. , 2003, European journal of dermatology : EJD.

[7]  M. Nicolson,et al.  Incidence of and survival from malignant melanoma in Scotland: an epidemiological study , 2002, The Lancet.

[8]  B. Kulle,et al.  Survival probabilities and hazard functions of malignant melanoma in Germany 1972-1996, an analysis of 10433 patients. Evolution of gender differences and malignancy. , 2002, European journal of cancer.

[9]  U. Ringborg,et al.  Trends in Incidence of Cutaneous Malignant Melanoma in a Swedish Population 1976-1994 , 2002, Acta oncologica.

[10]  K. Jöckel,et al.  Skin melanoma in Saarland: incidence, survival and mortality 1970–1996 , 2001, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[11]  D. Roberts,et al.  Malignant melanoma in South Wales: changing trends in presentation (1986–98) , 2001, Clinical and experimental dermatology.

[12]  S. Moss,et al.  Evaluation of primary prevention initiatives for skin cancer: a review from a U.K. perspective , 2000, The British journal of dermatology.

[13]  M. Coleman,et al.  Completeness of cancer registration: a new method for routine use , 2000, British Journal of Cancer.

[14]  D. Lipsker,et al.  Striking increase of thin melanomas contrasts with stable incidence of thick melanomas. , 1999, Archives of dermatology.

[15]  J. Naeyaert,et al.  Under-registration of melanoma in Belgium: an analysis. , 1999, Melanoma research.

[16]  Coebergh,et al.  Increase in and stabilization of incidence and mortality of primary cutaneous malignant melanoma in western Netherlands, 1980–95 , 1999, The British journal of dermatology.

[17]  J. Ferlay,et al.  Cancer Incidence in Five Continents , 1970, Union Internationale Contre Le Cancer / International Union against Cancer.

[18]  J. Melia,et al.  Problems with registration of cutaneous malignant melanoma in England. , 1995, British Journal of Cancer.

[19]  R. MacKie,et al.  Cutaneous malignant melanoma, Scotland, 1979-89 , 1992, The Lancet.

[20]  C. Patterson,et al.  Poor prognosis for malignant melanoma in Northern Ireland: a multivariate analysis. , 1991, British Journal of Cancer.

[21]  E. D. Vriesa,et al.  Lower incidence rates but thicker melanomas in Eastern Europe before 1992 : a comparison with Western Europe , 2004 .

[22]  J. Hunter,et al.  Cutaneous malignant melanoma, Scotland, 1979-89. The Scottish Melanoma Group. , 1992, Lancet.