Skin melanoma in Saarland: incidence, survival and mortality 1970–1996

Abstract

Over the past few decades, the incidence of cutaneous malignant melanoma has been rising in both sexes in almost all developed countries, notably those with fair-skinned populations. Detailed population-based time trend analyses of skin melanoma incidence and survival in Germany accounting for stage have not been published until now. We analysed skin melanoma data from the population-based Saarland Cancer Registry in Germany from 1970 to 1996. Incidence rates were age-standardized. We estimated 5-year disease-specific survival rates and evaluated the effects of sex, age, calendar period and staging on the prognosis in Cox's proportional hazards models. From 1970-1972 to 1994-1996, melanoma incidence increased 170% from 2.4 to 6.5 per 100 000 person-years among men and 150% from 2.4 to 6.0 per 100 000 person-years among women. Mortality rates peaked in 1988-1990. After 1988-1990, mortality rates declined among women and remained roughly constant among men. The increase in the incidence of localized melanoma and T1-T2 melanoma respectively is driving the overall incidence trend. The improvement of survival over time is most likely due to earlier detection of skin melanoma. In the 1990s, about 30% of all newly diagnosed skin melanoma had stage T3 or T4, implying that further improvement in survival by earlier detection is feasible.

A follow-up study of cutaneous melanoma cases and controls in Rosario, Argentina

“…Although the overall mortality rate of CMM has increased over the last 40 years, long-term survival rates are improving, mainly due to earlier tumour detection and treatment. In our study the distribution of gender and age of patients with CMM is consistent with European data (3,8,9,23,24). In line with other reports, we found anatomical distribution of melanoma to be sex-dependent.…”

“…Sunburn and intermittent sun exposure are the dominant environmental determinants of CMM risk, instead of large cumulative exposures of temperate climes (6,7). In addition to its increasing occurrence (3,(8)(9)(10) CMM patients seems to be at a greater risk of developing a second primary melanoma, non-melanoma skin cancers (NMSC), and primary noncutaneous malignancies compared with the general population (11)(12)(13)(14)(15)(16)(17)(18)(19). The aim of this study was to analyze the clinical features of patients with CMM in our area, characterized by a high proportion of European immigrant descendants.…”

Epidemiology of Melanoma

“…Like with melanoma incidence, among fair-skinned populations, melanoma mortality rate is highest in low-latitude regions (Figures 3 and 4) (9). In high-risk regions like New Zealand, Australia, North America, and Europe, mortality rates historically increased until the 1980s (97,98), peaked between 1988 and 1990, and then gradually maintained a slow increase (19,32,56,68,96,99,100). Over the last decade, mortality rate has steadily increased at 1.5% in the highest observed countries of New Zealand and Australia (19).…”

International trends in the incidence of malignant melanoma 1953–2008—are recent generations at higher or lower risk?

“…The incidence of melanoma has steadily increased over the last 50 years in most fair-skinned populations. [2][3][4][5][6] Such observations have been well documented in Europe 3,[7][8][9][10][11][12] (particularly in the Nordic countries), 2,3 North America, 13,14 Australia and New Zealand, 5,6 where incidence rates remain the highest reported worldwide. Nevertheless, several studies published during the last decade have reported rates in several of these populations as either stabilizing or declining, including a number of Northern and Western European countries, 3 the U.S., 13 Canada, 14 Australia 5,15 and New Zealand.…”