Cutaneous Malignant Melanoma in Central Iran: A 20-Year Study

Abstract

BackgroundSkin cancers are the most common cancers around the world. Cutaneous malignant melanoma (CMM) is the malignancy of melanocytes that are mainly located in the skin and mucous membranes.ObjectiveThis study tried to evaluate the incidence and mean survival time of cutaneous malignant melanoma (CMM) in Yazd, Iran. It seems that the epidemiology and clinical aspects of CMM in Iran are different from those in other parts of the world; also due to the limited and scattered studies there isn't lot in the literature regarding CMM in Iran.Materials and MethodsThis study used data obtained from the cancer registry center in the province of Yazd for a period of 21 years (1988 – 2008). Population and statistical data were gathered from “National Organization for Civil Registration”. Population-based data were analyzed, focusing on the incidence and mean survival time over this 21 year period.ResultsThe mean incidence rate for CMM in Yazd-Iran between 1988 and 2008 was 0.40 per 100,000 for males and 0.27 per 100,000 for females per year, and the incidence of CMM was relatively constant during this period of time. The mean survival rates for women were better than men (80.5% and 76.3% respectively).ConclusionsCMM in Yazd is a low-incidence skin tumor that shows a relatively fixed incidence between 1988 and 2008, Higher incidences of CMM were found in sun-exposed areas (especially head and neck areas), with more incidence in men. Skin cancers and CMM incidence in Iran is lower than western countries, most probably due to geographical zone, genetic factors, skin type, society-related customs including clothing styles.

Characteristic features of cutaneous melanoma in a dermatology referral centre in Tehran, Iran

“…The least common subtypes were superficial spreading melanoma (SSM; 9%) and amelanotic melanoma (0.7%). These results were similar to those reported from Egypt, Japan, the non‐white population in Brazil and also in a study conducted in the desert climate zone of Iran; whereas the most common subtype in white populations in Australia, the USA and European countries were of the SSM type …”

“…However, recent studies from Jordan, Egypt, Turkey and Taiwan reported an overall male predominance similar to our findings . A male predominance was also reported in a study performed from 1988 to 2008 in the central part of Iran …”

Incidence of cutaneous malignant melanoma in Iranian provinces and American states matched on ultraviolet radiation exposure: an ecologic study

“…Based on the UVR exposure map (Fig. 1A–C), Kerman (the southern province analyzed in our study) has higher erythemally-weighted average solar UVR exposure than Yazd, which may explain the higher rates of melanoma for Kerman in our study compared to those reported for Yazd in the cited reference (Noorbala et al, 2013). Another report from the population-based registry in the southern province of Fars (Fig.1A–C) found rates comparable to our study and increasing trends of melanoma for both genders.…”

“…Two previous studies, which analyzed melanoma rates using data from a single regional registry, found incidence rates compatible with ours. One study analyzed 20 years of data collected from the cancer registry of the province of Yazd in south central Iran during 1988–2008 and found the mean crude incidence rates of 0.40 per 100,000 person-years for males and 0.27 for females, with relatively fixed temporal trends (Noorbala et al, 2013). Yazd, a province with one million inhabitants, is located in the hot and dry desert area of the country with bright sunlight during most seasons.…”

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“…In a study conducted by Noorbala et al during 1988Noorbala et al during to 2008 in Yazd, a warm province in the center of Iran, the mean incidence rate for cutaneous malignant melanoma (CMM) was 0.40 per 100,000 for males and 0.27 per 100,000 for females yearly (15). Due to previously mentioned reasons, many studies have focused on Cyclooxygenase-2 (COX -2) as an inducible enzyme that is activated by UV radiation, and is a known risk factor for melanoma development (16)(17)(18).…”