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Bravo-Garzón MA, Bornstein-Quevedo L, de Camargo VP, Sanku G, Jansen AM, de Macedo MP, Rico-Restrepo M, Chacón M. BRAF-Mutated Melanoma Journey in Latin America: Expert Recommendations From Diagnosis to Treatment. Cancer Control 2024; 31:10732748241251572. [PMID: 38751033 PMCID: PMC11100406 DOI: 10.1177/10732748241251572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/28/2024] [Accepted: 04/10/2024] [Indexed: 05/19/2024] Open
Abstract
OBJECTIVES • Gather a panel of Latin American experts in testing and treating BRAF-melanoma. • Describe the current landscape of BRAF-mutated melanoma in Latin America. • Outline the current gaps in testing and recommend improvements for testing and treating BRAF-mutated melanoma in the region. INTRODUCTION Melanoma prevalence in Latin America is lower than in high- and middle-income countries. However, recent data indicate that the region's incidence and mortality are rising, with more stage IV patients being diagnosed. According to international clinical practice guidelines, conducting BRAF-mutation testing in patients with stage III or stage IV melanoma and high-risk resected disease is imperative. Still, BRAF-mutation testing and targeted therapies are inconsistently available in the region. METHODS Americas Health Foundation convened a meeting of Latin American experts on BRAF-mutated melanoma to develop guidelines and recommendations for diagnosis through treatment. RESULTS AND CONCLUSIONS Some recommendations for improving diagnostics through improving access and reducing the cost of BRAF-mutation testing, enhancing efficiency in pathology laboratories, and creating country-specific local guidelines. The panel also gave treatment recommendations for neo-adjuvant therapy, adjuvant therapy, and therapy for patients with metastatic disease in Latin America.
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Affiliation(s)
- María A. Bravo-Garzón
- Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center – CTIC, Bogotá D.C., Colombia
| | | | | | | | | | | | | | - Matías Chacón
- Alexander Fleming Institute, Buenos Aires, Argentina
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de Vries E, Uribe C, Beltrán Rodríguez CC, Caparros A, Meza E, Gil F. Descriptive Epidemiology of Melanoma Diagnosed between 2010 and 2014 in a Colombian Cancer Registry and a Call for Improving Available Data on Melanoma in Latin America. Cancers (Basel) 2023; 15:5848. [PMID: 38136393 PMCID: PMC10741499 DOI: 10.3390/cancers15245848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
We aimed to improve the available information on morphology and stage for cutaneous melanoma in the population-based cancer registry of the Bucaramanga Metropolitan Area in Colombia. The incidence and survival rates and the distribution of melanoma patients by age, gender, anatomical subsite, and histological subtype were calculated. All 113 melanoma patients (median age 61) were followed up (median time 7.4 years). This exercise (filling in missing information in the registry by manual search of patient clinical record and other available information) yielded more identified invasive melanomas and cases with complete information on anatomical localization and stage. Age-standardized incidence and mortality rates were 1.86 and 1.08, being slightly higher for males. Most melanomas were localized on the lower limbs, followed by the trunk. For 35% of all melanomas, the morphological subtype remained unknown. Most of the remaining melanomas were nodular and acral lentiginous melanomas. Overall global and relative 5-year survival was 61.6% and 71.3%, respectively, with poorer survival for males than females. Melanomas on the head and neck and unspecified anatomical sites had the worst survival. Patients without stage information in their medical files had excellent survival, unlike patients for whom medical files were no longer available. This study shows the possibility of improving data availability and the importance of good quality population-based data.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicina, Pontificia Universidad Javeriana, Ed. Hospital Universitario San Ignacio, Carrera 7 N° 40–62–piso 2, Bogotá 110231, Colombia;
| | - Claudia Uribe
- Population Based Cancer Registry of Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Calle 157 #14 55, Floridablanca 68276, Colombia; (C.U.); (E.M.)
| | | | - Alfredo Caparros
- MSD Medical Affairs Latin America, Cazadores de Coquimbo 2841/57, Munro, Vicente López, Buenos Aires B1605AZE, Argentina
| | - Erika Meza
- Population Based Cancer Registry of Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Calle 157 #14 55, Floridablanca 68276, Colombia; (C.U.); (E.M.)
| | - Fabian Gil
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicina, Pontificia Universidad Javeriana, Ed. Hospital Universitario San Ignacio, Carrera 7 N° 40–62–piso 2, Bogotá 110231, Colombia;
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Liu M, Wu M, Liu X, Zhou J, Lan Y, Zhang H, Zhang X, Leng L, Zheng H, Li J. Assessing the quality of care for skin malignant melanoma on a global, regional, and national scale: a systematic analysis of the global burden of disease study from 1990 to 2019. Arch Dermatol Res 2023; 315:2893-2904. [PMID: 37773351 PMCID: PMC10615953 DOI: 10.1007/s00403-023-02730-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/21/2023] [Accepted: 09/06/2023] [Indexed: 10/01/2023]
Abstract
Malignant melanoma (MM) is a highly aggressive form of skin cancer with increasing global incidence rates, particularly in developed countries. Variations in the prevalence and quality of care provided to patients with melanoma exist across different regions and across different sex and age. Assessing the global burden of melanoma and evaluating the quality of care can provide valuable insights for developing targeted interventions in certain underperforming regions and improving patient outcomes. This study aimed to systematically analyze the Global Burden of Disease Study from 1990 to 2019 to assess the quality of care for skin malignant melanoma on a global scale. We conducted a comprehensive literature review and extracted data on melanoma incidence, mortality, and disability-adjusted life years (DALYs) from the Global Burden of Disease Study. We incorporated these variables using principal component analysis (PCA) to form an informative single variable of quality of care index (QCI) and analyzed its spatial-temporal variations as well as disparities across age, sex and socio-demographic index (SDI). The overall Quality of Care Index (QCI) for melanoma improved from 82.81 in 1990 to 91.29 in 2019. The QCI score showed a positive correlation with socioeconomic status across regions. Australia ranked highest in QCI (99.96), while Central African Republic, and Kiribati had the lowest scores. China and Saudi Arabia showed significant QCI improvement, while the QCI of the Democratic People's Republic of Korea, Zimbabwe, and Guam decreased from 1990 to 2019. The highest QCI scores were observed in the age groups of 20-39 years old (93.40-94.65). Gender disparities narrowed globally in these three decades, but lower Socio-demographic Index (SDI) regions showed increased gender inequities. Our findings highlighted the spatial-temporal variations in the quality of care of MM as well as its disparities across different SDI levels, age groups and sex. These findings offer valuable insights and guidance for implementing focused interventions and resource allocation to enhance the quality of care and overall outcomes for MM worldwide, especially for underperforming regions.
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Affiliation(s)
- Mingjuan Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
- 4+4 M.D. Program, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Mengyin Wu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Xintong Liu
- Peking University Health Science Center, Beijing, 100191, China
| | - Jia Zhou
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Yining Lan
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Hanlin Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Xinyi Zhang
- Departments of Internal Medicine and Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, USA
| | - Ling Leng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Heyi Zheng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Jun Li
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.
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Schuty B, Martínez S, Guerra A, Lecumberry F, Magliano J, Malacrida L. Quantitative melanoma diagnosis using spectral phasor analysis of hyperspectral imaging from label-free slices. Front Oncol 2023; 13:1296826. [PMID: 38162497 PMCID: PMC10756080 DOI: 10.3389/fonc.2023.1296826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/31/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Melanoma diagnosis traditionally relies on microscopic examination of hematoxylin and eosin (H&E) slides by dermatopathologists to search for specific architectural and cytological features. Unfortunately, no single molecular marker exists to reliably differentiate melanoma from benign lesions such as nevi. This study explored the potential of autofluorescent molecules within tissues to provide molecular fingerprints indicative of degenerated melanocytes in melanoma. Methods Using hyperspectral imaging (HSI) and spectral phasor analysis, we investigated autofluorescence patterns in melanoma compared to intradermal nevi. Using UV excitation and a commercial spectral confocal microscope, we acquired label-free HSI data from the whole-slice samples. Results Our findings revealed distinct spectral phasor distributions between melanoma and intradermal nevi, with melanoma displaying a broader phasor phase distribution, signifying a more heterogeneous autofluorescence pattern. Notably, longer wavelengths associated with larger phases correlated with regions identified as melanoma by expert dermatopathologists using H&E staining. Quantitative analysis of phase and modulation histograms within the phasor clusters of five melanomas (with Breslow thicknesses ranging from 0.5 mm to 6 mm) and five intradermal nevi consistently highlighted differences between the two groups. We further demonstrated the potential for the discrimination of several melanocytic lesions using center-of-mass comparisons of phase and modulation variables. Remarkably, modulation versus phase center of mass comparisons revealed strong statistical significance among the groups. Additionally, we identified the molecular endogenous markers responsible for tissue autofluorescence, including collagen, elastin, NADH, FAD, and melanin. In melanoma, autofluorescence is characterized by a higher phase contribution, indicating an increase in FAD and melanin in melanocyte nests. In contrast, NADH, elastin, and collagen dominate the autofluorescence of the nevus. Discussion This work underscores the potential of autofluorescence and HSI-phasor analysis as valuable tools for quantifying tissue molecular fingerprints, thereby supporting more effective and quantitative melanoma diagnosis.
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Affiliation(s)
- Bruno Schuty
- Unidad de Bioimagenología Avanzada, Institut Pasteur de Montevideo, Hospital de Clínicas Universidad de la República, Montevideo, Uruguay
| | - Sofía Martínez
- Unidad de Bioimagenología Avanzada, Institut Pasteur de Montevideo, Hospital de Clínicas Universidad de la República, Montevideo, Uruguay
- Unidad Academica de Dermatología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Analía Guerra
- Unidad Academica de Dermatología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Federico Lecumberry
- Instituto de Ingeniería Eléctrica, Facultad de Ingeniería, Universidad de la República, Montevideo, Uruguay
| | - Julio Magliano
- Unidad Academica de Dermatología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Leonel Malacrida
- Unidad de Bioimagenología Avanzada, Institut Pasteur de Montevideo, Hospital de Clínicas Universidad de la República, Montevideo, Uruguay
- Unidad Academica de Fisiopatología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
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Kunonga TP, Kenny RPW, Astin M, Bryant A, Kontogiannis V, Coughlan D, Richmond C, Eastaugh CH, Beyer FR, Pearson F, Craig D, Lovat P, Vale L, Ellis R. Predictive accuracy of risk prediction models for recurrence, metastasis and survival for early-stage cutaneous melanoma: a systematic review. BMJ Open 2023; 13:e073306. [PMID: 37770261 PMCID: PMC10546114 DOI: 10.1136/bmjopen-2023-073306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/03/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES To identify prognostic models for melanoma survival, recurrence and metastasis among American Joint Committee on Cancer stage I and II patients postsurgery; and evaluate model performance, including overall survival (OS) prediction. DESIGN Systematic review and narrative synthesis. DATA SOURCES Searched MEDLINE, Embase, CINAHL, Cochrane Library, Science Citation Index and grey literature sources including cancer and guideline websites from 2000 to September 2021. ELIGIBILITY CRITERIA Included studies on risk prediction models for stage I and II melanoma in adults ≥18 years. Outcomes included OS, recurrence, metastases and model performance. No language or country of publication restrictions were applied. DATA EXTRACTION AND SYNTHESIS Two pairs of reviewers independently screened studies, extracted data and assessed the risk of bias using the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies checklist and the Prediction study Risk of Bias Assessment Tool. Heterogeneous predictors prevented statistical synthesis. RESULTS From 28 967 records, 15 studies reporting 20 models were included; 8 (stage I), 2 (stage II), 7 (stages I-II) and 7 (stages not reported), but were clearly applicable to early stages. Clinicopathological predictors per model ranged from 3-10. The most common were: ulceration, Breslow thickness/depth, sociodemographic status and site. Where reported, discriminatory values were ≥0.7. Calibration measures showed good matches between predicted and observed rates. None of the studies assessed clinical usefulness of the models. Risk of bias was high in eight models, unclear in nine and low in three. Seven models were internally and externally cross-validated, six models were externally validated and eight models were internally validated. CONCLUSIONS All models are effective in their predictive performance, however the low quality of the evidence raises concern as to whether current follow-up recommendations following surgical treatment is adequate. Future models should incorporate biomarkers for improved accuracy. PROSPERO REGISTRATION NUMBER CRD42018086784.
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Affiliation(s)
- Tafadzwa Patience Kunonga
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - R P W Kenny
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Margaret Astin
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Bryant
- Biostatistics Research Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Vasileios Kontogiannis
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Diarmuid Coughlan
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Richmond
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Claire H Eastaugh
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona R Beyer
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Pearson
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- NIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Penny Lovat
- Dermatological Sciences, Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- AMLo Bisciences, The Biosphere, Newcastle Helix, Newcastle upon Tyne, UK
| | - Luke Vale
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Robert Ellis
- Dermatological Sciences, Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- AMLo Bisciences, The Biosphere, Newcastle Helix, Newcastle upon Tyne, UK
- Department of Dermatology, South Tees Hospitals NHS FT, Middlesbrough, UK
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Salman P, de Melo AC, Rico-Restrepo M, Rodriguez J, Russi A, Schmerling RA, Zambrano A, Cinat G. Addressing the unmet needs of patients with BRAF-mutated melanoma in Latin America: Expert perspective. Front Oncol 2023; 13:1032300. [PMID: 36998456 PMCID: PMC10043339 DOI: 10.3389/fonc.2023.1032300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
Melanoma represents an increasing public health burden with extensive unmet needs in Latin America (LA). A mutation in the BRAF gene is present in approximately 50% of all melanomas in White populations and is a target of precision medicine, with the potential to dramatically improve patient outcomes. Thus, increased access to BRAF testing and therapy is LA must be explored. At a multi-day conference, a panel of Latin American experts in oncology and dermatology were provided with questions to address the barriers limiting access to testing for BRAF mutation in patients with melanoma in LA, who may be eligible for targeted therapy to improve their prognosis. During the conference, responses were discussed and edited until a consensus on addressing the barriers was achieved. Identified challenges included ignorance of BRAF-status implications, limited human and infrastructural resources, affordability and reimbursement, fragmented care delivery, pitfalls in the sample journey, and lack of local data. Despite the clear benefits of targeted therapies for BRAF-mutated melanoma in other regions, there is no clear path to prepare LA for a sustainable personalized medicine approach to this disease. Due to melanoma’s time-sensitive nature, LA must aim to provide early access to BRAF testing and consider mutational status within treatment decision making. To this end, recommendations are provided and include establishing multidisciplinary teams and melanoma referral centers and improving access to diagnosis and treatment.
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Affiliation(s)
- Pamela Salman
- Oncology Department, Oncovida Cancer Center, Santiago, Chile
- *Correspondence: Pamela Salman,
| | | | | | | | - Andrea Russi
- Departamento de Oncología, Hospital Universitario San Ignacio, Centro Javeriano de Oncología, Bogotá, Colombia
| | | | - Angela Zambrano
- Departamento de Oncología, Fundación Valle del Lili, Cali, Colombia
| | - Gabriela Cinat
- Instituto de Oncología Ángel Roffo, Universidad de Buenos Aires, Fundación CIDEA, Buenos Aires, Argentina
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Gallo Marin B, Zheng DX, Gamboa DM, Frech FS, Amaya A, Mulligan KM, Oliva R, Soto A, Kuhn H. Contextualization of skin cancer incidence rates across Costa Rican provinces. Int J Dermatol 2022; 61:e478-e480. [PMID: 34813092 PMCID: PMC9124717 DOI: 10.1111/ijd.16010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/23/2021] [Accepted: 11/11/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Benjamin Gallo Marin
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - David X. Zheng
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | | | - Fabio Stefano Frech
- Department of Dermatology, Miller School of Medicine, University of Miami, Miami, Florida, United States
| | - Andres Amaya
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - Kathleen M. Mulligan
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Rocío Oliva
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | | | - Helena Kuhn
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
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Di Carlo V, Stiller CA, Eisemann N, Bordoni A, Matz M, Curado MP, Daubisse‐Marliac L, Valkov M, Bulliard J, Morrison D, Johnson C, Girardi F, Marcos‐Gragera R, Šekerija M, Larønningen S, Sirri E, Coleman MP, Allemani C. Does the morphology of cutaneous melanoma help to explain the international differences in survival? Results from 1 578 482 adults diagnosed during 2000-2014 in 59 countries (CONCORD-3). Br J Dermatol 2022; 187:364-380. [PMID: 35347700 PMCID: PMC9542891 DOI: 10.1111/bjd.21274] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/18/2022] [Accepted: 03/27/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND CONCORD-3 highlighted wide disparities in population-based 5-year net survival for cutaneous melanoma during 2000-2014. Clinical evidence suggests marked international differences in the proportion of lethal acral and nodular subtypes of cutaneous melanoma. OBJECTIVES We aimed to assess whether the differences in morphology may explain global variation in survival. METHODS Patients with melanoma were grouped into the following seven morphological categories: malignant melanoma, not otherwise specified (International Classification of Diseases for Oncology, third revision morphology code 8720), superficial spreading melanoma (8743), lentigo maligna melanoma (8742), nodular melanoma (8721), acral lentiginous melanoma (8744), desmoplastic melanoma (8745) and other morphologies (8722-8723, 8726-8727, 8730, 8740-8741, 8746, 8761, 8770-8774, 8780). We estimated net survival using the nonparametric Pohar Perme estimator, correcting for background mortality by single year of age, sex and calendar year in each country or region. All-ages survival estimates were standardized using the International Cancer Survival Standard weights. We fitted a flexible parametric model to estimate the effect of morphology on the hazard of death. RESULTS Worldwide, the proportion of nodular melanoma ranged between 7% and 13%. Acral lentiginous melanoma accounted for less than 2% of all registrations but was more common in Asia (6%) and Central and South America (7%). Overall, 36% of tumours were classified as superficial spreading melanoma. During 2010-2014, age-standardized 5-year net survival for superficial spreading melanoma was 95% or higher in Oceania, North America and most European countries, but was only 71% in Taiwan. Survival for acral lentiginous melanoma ranged between 66% and 95%. Nodular melanoma had the poorest prognosis in all countries. The multivariable analysis of data from registries with complete information on stage and morphology found that sex, age and stage at diagnosis only partially explain the higher risk of death for nodular and acral lentiginous subtypes. CONCLUSIONS This study provides the broadest picture of distribution and population-based survival trends for the main morphological subtypes of cutaneous melanoma in 59 countries. The poorer prognosis for nodular and acral lentiginous melanomas, more frequent in Asia and Latin America, suggests the need for health policies aimed at specific populations to improve awareness, early diagnosis and access to treatment. What is already known about this topic? The histopathological features of cutaneous melanoma vary markedly worldwide. The proportion of melanomas with the more aggressive acral lentiginous or nodular histological subtypes is higher in populations with predominantly dark skin than in populations with predominantly fair skin. What does this study add? We aimed to assess the extent to which these differences in morphology may explain international variation in survival when all histological subtypes are combined. This study provides, for the first time, international comparisons of population-based survival at 5 years for the main histological subtypes of melanoma for over 1.5 million adults diagnosed during 2000-2014. This study highlights the less favourable distribution of histological subtypes in Asia and Central and South America, and the poorer prognosis for nodular and acral lentiginous melanomas. We found that later stage at diagnosis does not fully explain the higher excess risk of death for nodular and acral lentiginous melanoma compared with superficial spreading melanoma.
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Affiliation(s)
- Veronica Di Carlo
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
| | | | - Nora Eisemann
- Institute of Social Medicine and Epidemiology, University of LübeckRatzeburger Allee160 23538LübeckGermany
| | - Andrea Bordoni
- Ticino Cancer Registry, Dipartimento Sanità e SocialitàDivisione della Salute PubblicaVia Ciseri10 6600LocarnoSwitzerland
| | - Melissa Matz
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
| | - Maria P. Curado
- Goiânia Cancer Registry, Group of Epidemiology and Statistics on CancerAC Camargo Cancer CenterRua Tamandaré 753 ‐ LiberdadeSP01525‐001São PauloBrazil
| | - Laetitia Daubisse‐Marliac
- Tarn Cancer RegistryInstitut Universitaire du Cancer Toulouse – Oncopole Institut C. Regaud1 Avenue Irène Joliot‐Curie31059ToulouseFrance
| | - Mikhail Valkov
- Northern State Medical UniversityProspekt Troitskiy51 163000ArkhangelskRussian Federation
| | - Jean‐Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté)University of LausanneLausanneSwitzerland
- Neuchâtel and Jura Tumour RegistryNeuchâtelSwitzerland
| | - David Morrison
- Scottish Cancer RegistryGyle Square, 1 South Gyle CrescentEH12 9EBEdinburghUK
| | - Chris Johnson
- Cancer Data Registry of Idaho, 615 North 7th StreetID83701‐1278BoiseUSA
| | - Fabio Girardi
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
- Cancer DivisionUniversity College London Hospitals NHS Foundation TrustEuston RoadWC1H 8NJLondonUK
- Division of Medical Oncology 2Veneto Institute of Oncology IOV‐IRCCSVia Gattamelata64 35128PadovaItaly
| | - Rafael Marcos‐Gragera
- Epidemiology Unit and Girona Cancer RegistryCatalan Institute of Oncology (ICO), IDIBGI, Oncology Coordination Plan, Department of Health Government of Catalonia17004GironaSpain
- University of Girona (UdG)17004GironaSpain
- CIBER of Epidemiology and Public Health (CIBERESP)MadridSpain
| | - Mario Šekerija
- Croatian National Cancer RegistryCroatian Institute of Public HealthRockefeller Street7 10000ZagrebCroatia
| | | | - Eunice Sirri
- Epidemiological Cancer Registry of Lower SaxonyOffis Caree GmbHIndustriestr92 6121OldenburgGermany
| | - Michel P. Coleman
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
- Cancer DivisionUniversity College London Hospitals NHS Foundation TrustEuston RoadWC1H 8NJLondonUK
| | - Claudia Allemani
- Cancer Survival GroupLondon School of Hygiene and Tropical MedicineKeppel StreetWC1E 7HTLondonUK
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Meijs M, Herrera A, Acosta A, de Vries E. Burden of skin cancer in Colombia. Int J Dermatol 2022; 61:1003-1011. [PMID: 35141880 DOI: 10.1111/ijd.16077] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 10/31/2021] [Accepted: 12/31/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Levels of incidence and mortality of skin cancer in Colombia and Latin America are largely unknown. OBJECTIVES Present the available information from official and gray literature and governmental databases to grasp the magnitude and characteristics of skin cancer in Colombia (middle-income Latin American country). METHODS Narrative review based on a literature search (2005-2020), gray literature and cancer registry and governmental warehouse data, calculation of proportions and age-standardized incidence (ASIR) and mortality rates (ASMR), expressed per 100,000 person-years. RESULTS ASIR of cutaneous melanoma in Colombia is around 3, corresponding ASMR between 0.7 and 0.8. Distinctive features are the high proportion and rates for acral melanomas, and the advanced stage at diagnosis in the general population but not in private clinics. For non-melanoma skin cancer, ASIR is at least around 35-40, ASMR 0.8. CONCLUSIONS Among the wealthy Colombians, melanoma features are similar to those of high incidence countries (but of lower magnitude), whereas the majority of the population present distinct features with a much higher proportion of acral melanomas, very late stages at diagnosis, and poor prognosis. More advanced melanomas seem to have a relation with lower socioeconomic status. Non-melanoma skin cancer is common, with very high mortality rates at levels even above those of predominantly fair-skinned populations, implying high fatality rates for non-melanoma skin cancers. This could indicate a late diagnosis or difficulties in access to treatment, illustrating the need for primary and secondary prevention to reduce the burden of disease and improve the prognosis of this common cancer.
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Affiliation(s)
- Martijn Meijs
- Department of Dermatology, Bovenij Hospital Amsterdam, Amsterdam, the Netherlands
| | | | - Alvaro Acosta
- Department of Dermatology, Nacional Cancer Institute of Colombia, Bogotá, Colombia
| | - Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia
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10
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Rodríguez-Betancourt JD, Arias-Ortiz N. Cutaneous melanoma incidence, mortality, and survival in Manizales, Colombia: a population-based study. J Int Med Res 2022; 50:3000605221106706. [PMID: 35722901 PMCID: PMC9344176 DOI: 10.1177/03000605221106706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We estimated the cutaneous melanoma (CM) incidence, mortality, and survival in Manizales, Colombia to establish predictors for survival. METHODS This analytical cohort study used CM incident cases during 2006 to 2015 in the Manizales Cancer Registry (n = 132). Incidence and mortality rates were standardized using the direct method. Patients were followed up until 30 November 2020. Cause-specific survival was calculated using the Kaplan-Meier method for variables of interest, with the log-rank test for differences. Cox multivariate regression models were fitted. RESULTS Incidence (per 100,000) increased from 1.6 to 3.0 in men and 2.6 to 2.8 in women during 2006-2010 to 2011-2015, respectively. Mortality was low and stable. Five-year survival was 68.7%, with significant differences according to age (hazard ratio [HR] >70 vs. ≤70 years: 3.37); histological subtype (HR for melanoma not otherwise specified and HR for nodular melanoma vs lentigo malignant melanoma and superficial spreading melanoma: 17.39 and 10.16, respectively); and clinical stage (HR stages III-IV vs. stages I-II: 5.94). CONCLUSION CM is characterized by increasing incidence and unfavorable prognosis, particularly in patients aged >70 years, with melanoma not otherwise specified and nodular melanoma, and advanced stages. Promoting photoprotection and early detection and management of suspicious skin lesions is crucial.
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Affiliation(s)
- Juan David Rodríguez-Betancourt
- Young Researchers Program, Ministerio de Ciencia, Tecnología e
Innovación, Bogotá, Colombia
- Population-based Manizales Cancer Registry, Instituto de
Investigaciones en Salud, Universidad de Caldas, Manizales, Colombia
- Departamento de Salud Pública, Universidad de Caldas, Manizales,
Colombia
| | - Nelson Arias-Ortiz
- Population-based Manizales Cancer Registry, Instituto de
Investigaciones en Salud, Universidad de Caldas, Manizales, Colombia
- Departamento de Salud Pública, Universidad de Caldas, Manizales,
Colombia
- Grupo de Investigación Promoción de la Salud y Prevención de la
Enfermedad, Universidad de Caldas, Manizales, Colombia
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11
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Arnold M, Singh D, Laversanne M, Vignat J, Vaccarella S, Meheus F, Cust AE, de Vries E, Whiteman DC, Bray F. Global Burden of Cutaneous Melanoma in 2020 and Projections to 2040. JAMA Dermatol 2022; 158:495-503. [PMID: 35353115 PMCID: PMC8968696 DOI: 10.1001/jamadermatol.2022.0160] [Citation(s) in RCA: 314] [Impact Index Per Article: 157.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/16/2022] [Indexed: 12/15/2022]
Abstract
Importance Despite many cases being preventable, cutaneous melanoma remains the most serious skin cancer worldwide. Understanding the scale and profile of the disease is vital to concentrate and reinforce global prevention efforts. Objective To examine global patterns of cutaneous melanoma in 2020 and to provide projected estimates of cases and deaths by 2040. Design, Setting, and Participants This population-based study used the GLOBOCAN 2020 database for global epidemiological assessment of new cases and deaths due to invasive melanoma. Main Outcomes and Measures Age-standardized incidence and mortality rates were calculated per 100 000 person-years by country, world region, and 4-tier level of human development. Estimated numbers of cases and deaths were calculated for the year 2040. Results A worldwide total of 325 000 new melanoma cases (174 000 males, 151 000 females) and 57 000 deaths (32 000 males, 25 000 females) was estimated for 2020. Large geographic variations existed across countries and world regions, with the highest incidence rates among males (42 per 100 000 person-years) and females (31 per 100 000 person-years) observed in Australia/New Zealand, followed by Western Europe (19 per 100 000 person-years for males and females), North America (18 per 100 000 person-years for males, 14 per 100 000 person-years for females), and Northern Europe (17 per 100 000 person-years for males, 18 per 100 000 person-years for females). Melanoma continued to be rare in most African and Asian countries, with incidence rates commonly less than 1 per 100 000 person-years. Mortality rates peaked at 5 per 100 000 person-years in New Zealand, and geographic variations were less pronounced than for incidence. Melanoma was more frequent among males than females in most world regions. If 2020 rates continue, the burden from melanoma is estimated to increase to 510 000 new cases (a roughly 50% increase) and to 96 000 deaths (a 68% increase) by 2040. Conclusions and Relevance This epidemiological assessment suggests that melanoma remains an important challenge to cancer control and public health globally, especially in fair-skinned populations of European descent.
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Affiliation(s)
- Melina Arnold
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Deependra Singh
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Jerome Vignat
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Salvatore Vaccarella
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Filip Meheus
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Anne E. Cust
- The Daffodil Centre, The University of Sydney with Cancer Council New South Wales, Sydney, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - David C. Whiteman
- Cancer Control Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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12
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Vale L, Kunonga P, Coughlan D, Kontogiannis V, Astin M, Beyer F, Richmond C, Wilson D, Bajwa D, Javanbakht M, Bryant A, Akor W, Craig D, Lovat P, Labus M, Nasr B, Cunliffe T, Hinde H, Shawgi M, Saleh D, Royle P, Steward P, Lucas R, Ellis R. Optimal surveillance strategies for patients with stage 1 cutaneous melanoma post primary tumour excision: three systematic reviews and an economic model. Health Technol Assess 2021; 25:1-178. [PMID: 34792018 DOI: 10.3310/hta25640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Malignant melanoma is the fifth most common cancer in the UK, with rates continuing to rise, resulting in considerable burden to patients and the NHS. OBJECTIVES The objectives were to evaluate the effectiveness and cost-effectiveness of current and alternative follow-up strategies for stage IA and IB melanoma. REVIEW METHODS Three systematic reviews were conducted. (1) The effectiveness of surveillance strategies. Outcomes were detection of new primaries, recurrences, metastases and survival. Risk of bias was assessed using the Cochrane Collaboration's Risk-of-Bias 2.0 tool. (2) Prediction models to stratify by risk of recurrence, metastases and survival. Model performance was assessed by study-reported measures of discrimination (e.g. D-statistic, Harrel's c-statistic), calibration (e.g. the Hosmer-Lemeshow 'goodness-of-fit' test) or overall performance (e.g. Brier score, R 2). Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). (3) Diagnostic test accuracy of fine-needle biopsy and ultrasonography. Outcomes were detection of new primaries, recurrences, metastases and overall survival. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Review data and data from elsewhere were used to model the cost-effectiveness of alternative surveillance strategies and the value of further research. RESULTS (1) The surveillance review included one randomised controlled trial. There was no evidence of a difference in new primary or recurrence detected (risk ratio 0.75, 95% confidence interval 0.43 to 1.31). Risk of bias was considered to be of some concern. Certainty of the evidence was low. (2) Eleven risk prediction models were identified. Discrimination measures were reported for six models, with the area under the operating curve ranging from 0.59 to 0.88. Three models reported calibration measures, with coefficients of ≥ 0.88. Overall performance was reported by two models. In one, the Brier score was slightly better than the American Joint Committee on Cancer scheme score. The other reported an R 2 of 0.47 (95% confidence interval 0.45 to 0.49). All studies were judged to have a high risk of bias. (3) The diagnostic test accuracy review identified two studies. One study considered fine-needle biopsy and the other considered ultrasonography. The sensitivity and specificity for fine-needle biopsy were 0.94 (95% confidence interval 0.90 to 0.97) and 0.95 (95% confidence interval 0.90 to 0.97), respectively. For ultrasonography, sensitivity and specificity were 1.00 (95% confidence interval 0.03 to 1.00) and 0.99 (95% confidence interval 0.96 to 0.99), respectively. For the reference standards and flow and timing domains, the risk of bias was rated as being high for both studies. The cost-effectiveness results suggest that, over a lifetime, less intensive surveillance than recommended by the National Institute for Health and Care Excellence might be worthwhile. There was considerable uncertainty. Improving the diagnostic performance of cancer nurse specialists and introducing a risk prediction tool could be promising. Further research on transition probabilities between different stages of melanoma and on improving diagnostic accuracy would be of most value. LIMITATIONS Overall, few data of limited quality were available, and these related to earlier versions of the American Joint Committee on Cancer staging. Consequently, there was considerable uncertainty in the economic evaluation. CONCLUSIONS Despite adoption of rigorous methods, too few data are available to justify changes to the National Institute for Health and Care Excellence recommendations on surveillance. However, alternative strategies warrant further research, specifically on improving estimates of incidence, progression of recurrent disease; diagnostic accuracy and health-related quality of life; developing and evaluating risk stratification tools; and understanding patient preferences. STUDY REGISTRATION This study is registered as PROSPERO CRD42018086784. FUNDING This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol 25, No. 64. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Luke Vale
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Patience Kunonga
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Diarmuid Coughlan
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Margaret Astin
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Beyer
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Richmond
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dor Wilson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dalvir Bajwa
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Mehdi Javanbakht
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Bryant
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Wanwuri Akor
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Dawn Craig
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Penny Lovat
- Institute of Translation and Clinical Studies, Newcastle University, Newcastle upon Tyne, UK
| | - Marie Labus
- Business Development and Enterprise, Newcastle University, Newcastle upon Tyne, UK
| | - Batoul Nasr
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Timothy Cunliffe
- Dermatology Department, James Cook University Hospital, Middlesbrough, UK
| | - Helena Hinde
- Dermatology Department, James Cook University Hospital, Middlesbrough, UK
| | - Mohamed Shawgi
- Radiology Department, James Cook University Hospital, Middlesbrough, UK
| | - Daniel Saleh
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.,Princess Alexandra Hospital Southside Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Pam Royle
- Patient representative, ITV Tyne Tees, Gateshead, UK
| | - Paul Steward
- Patient representative, Dermatology Department, James Cook University Hospital, Middlesbrough, UK
| | - Rachel Lucas
- Patient representative, Dermatology Department, James Cook University Hospital, Middlesbrough, UK
| | - Robert Ellis
- Institute of Translation and Clinical Studies, Newcastle University, Newcastle upon Tyne, UK.,South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
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13
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Risk Factors for Melanoma in a Latin American Population: A Case-Control Study. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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14
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Bernardes SS, Ferreira I, Elder DE, Nobre AB, Martínez‐Said H, Adams DJ, Robles‐Espinoza CD, Possik PA. More than just acral melanoma: the controversies of defining the disease. J Pathol Clin Res 2021; 7:531-541. [PMID: 34213090 PMCID: PMC8503895 DOI: 10.1002/cjp2.233] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/13/2021] [Accepted: 06/09/2021] [Indexed: 01/17/2023]
Abstract
Acral melanoma (AM) is a malignant cutaneous melanocytic tumour specifically located on the palms, soles, and nail apparatus, which are areas of glabrous (hairless) skin. Acral lentiginous melanoma, a subtype of AM, represents a histopathological subtype diagnosis of cutaneous melanoma with unique morphological and structural features. Despite clear definitions, the misuse of these terms and the inconsistency in reporting the histopathological features of AM cases have become a major obstacle to the study of the disease. In this review, we discuss the epidemiology, histopathological features, prognosis, and genetic profile of AM, highlighting the differences observed when histopathological subtypes are considered. The increasing global effort to characterise AM cases from ethnically diverse populations would benefit greatly from a more consistent classification of the disease.
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Affiliation(s)
- Sara S Bernardes
- Program of Immunology and Tumour BiologyBrazilian National Cancer InstituteRio de JaneiroBrazil
- Tissue Microenvironment Laboratory, Department of General PathologyFederal University of Minas GeraisBelo HorizonteBrazil
| | - Ingrid Ferreira
- Experimental Cancer GeneticsWellcome Sanger InstituteHinxtonUK
- Université Libre de BruxellesBrusselsBelgium
| | - David E Elder
- Division of Anatomic PathologyHospital of the University of PennsylvaniaPhiladelphiaPAUSA
| | - Aretha B Nobre
- Division of PathologyBrazilian National Cancer InstituteRio de JaneiroBrazil
- Serviço de Patologia, Maternidade EscolaUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
| | - Héctor Martínez‐Said
- Servicio de Piel y Partes BlandasInstituto Nacional de CancerologíaCiudad de MéxicoMexico
| | - David J Adams
- Experimental Cancer GeneticsWellcome Sanger InstituteHinxtonUK
| | - Carla Daniela Robles‐Espinoza
- Experimental Cancer GeneticsWellcome Sanger InstituteHinxtonUK
- Laboratorio Internacional de Investigación sobre el Genoma HumanoUniversidad Nacional Autónoma de MéxicoSantiago de QuerétaroMexico
| | - Patricia A Possik
- Program of Immunology and Tumour BiologyBrazilian National Cancer InstituteRio de JaneiroBrazil
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15
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Aguirre L, Muñoz A, Aluma-Tenorio M, Jaimes N. Factores de riesgo para melanoma en una población latinoamericana: estudio de casos y controles. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.ad.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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16
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Fernandez-Quiroz EL, Gonzales-Chachapoyas L, Alcantara-Diaz AL, Bulnes-Villalta B, Ayala-Porras Z, Toro-Huamanchumo CJ. Sunburns among beachgoers in the northern coast of Peru: frequency and factors associated. PeerJ 2021; 9:e11473. [PMID: 34178442 PMCID: PMC8197030 DOI: 10.7717/peerj.11473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background Overexposure to ultraviolet (UV) radiation has increased skin cancer incidence and the risk of sunburns, especially during the summer months. Objective Identify the frequency and factors associated with sunburns in a sample of beachgoers in the northern coast of Peru. Methods We conducted a secondary data analysis of a previous study that assessed the awareness, behavior and attitudes concerning sun exposure among beachgoers. We included adults between 18 and 59 years who went to a beach in northern Peru during summer (March 2018). Three generalized linear models of the Poisson family were constructed to evaluate the factors associated with having had at least one sunburn last summer. All regression models reported the adjusted prevalence ratio (aPR) with their respective 95% confidence interval (95% CI). Results Of a total of 402 participants, 225 (56.0%) had one to five sunburns and 25 (6.2%) had six or more. Beachgoers who were 1–15 days (aPR: 1.16, 95% CI [1.05–1.27]) or more than 15 days (aPR: 1.22, 95% CI [1.09–1.36]) exposed to the sun on the beach had a higher frequency of at least one sunburn. The non-regular wearing of a hat or cap also increased the frequency of sunburns (aPR: 1.06, 95% CI [1.01–1.12]). In contrast, those who had Skin Phototype III (aPR: 0.94, 95% CI [0.88–0.99]) or IV (aPR: 0.69, 95% CI [0.63–0.75]) had a lower frequency of sunburns. Conclusion Three out of five beachgoers had one or more sunburns in the last summer. The factors associated with a higher frequency were the time of sun exposure at the beach and the non-regular use of a hat or cap. Type III–IV skin phototypes were associated with a lower sunburn frequency.
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Affiliation(s)
- Eliana L Fernandez-Quiroz
- Universidad Católica Santo Toribio de Mogrovejo, Chiclayo, Peru.,Asociación Científica de Estudiantes de Medicina de la Universidad Católica Santo Toribio de Mogrovejo - ASOCIEM USAT, Chiclayo, Peru
| | - Lizeth Gonzales-Chachapoyas
- Universidad Católica Santo Toribio de Mogrovejo, Chiclayo, Peru.,Asociación Científica de Estudiantes de Medicina de la Universidad Católica Santo Toribio de Mogrovejo - ASOCIEM USAT, Chiclayo, Peru
| | - Ana L Alcantara-Diaz
- Sociedad Científica de Estudiantes de Medicina Veritas, Chiclayo, Peru.,Universidad de San Martín de Porres, Facultad de Medicina Humana, Chiclayo, Peru
| | - Binz Bulnes-Villalta
- Universidad Católica Santo Toribio de Mogrovejo, Chiclayo, Peru.,Asociación Científica de Estudiantes de Medicina de la Universidad Católica Santo Toribio de Mogrovejo - ASOCIEM USAT, Chiclayo, Peru
| | - Zulmy Ayala-Porras
- Sociedad Científica de Estudiantes de Medicina Veritas, Chiclayo, Peru.,Universidad de San Martín de Porres, Facultad de Medicina Humana, Chiclayo, Peru
| | - Carlos J Toro-Huamanchumo
- Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
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17
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Núñez-González S, Bedoya E, Simancas-Racines D, Gault C. Spatial clusters and temporal trends of malignant melanoma mortality in Ecuador. SAGE Open Med 2020; 8:2050312120918285. [PMID: 32435484 PMCID: PMC7222651 DOI: 10.1177/2050312120918285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 03/05/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The aim of this study is two fold. First, it describes the temporal trends of malignant melanoma mortality from 2000 to 2016 in Ecuador. Second, it analyzes the spatial clusters of high mortality rates due to malignant melanoma in the country, from 2011 to 2016. METHODS This is an ecological study; we included all death certificates of malignant melanoma from the National Institute of Statistics and Census database in Ecuador from 2000 to 2016. We calculated crude mortality rates and age-standardized mortality rates, all rates are expressed as deaths per 100,000 population. In order to assess the trend of malignant melanoma rates, we obtained average annual percent changes through Joinpoint regression analysis. Spatial scan statistics were used to identify high-risk clusters and the spatial autocorrelation was evaluated through a global Moran index. RESULTS In Ecuador, between 2000 and 2016, malignant melanoma caused a total of 958 deaths. Crude mortality rates increased significantly (annual percent change = 4.8%; 95% confidence interval: 2.6-7.0), the age-standardized mortality rate also increased (annual percent change: 2.9%; 95% confidence interval: 0.5-5.4). The most likely cluster included 19 cantons and the second most likely cluster included 10 cantons, located in the Highlands region. The Global Moran I index for the study period shows a positive spatial autocorrelation (0.32; p = 0.001). CONCLUSION Mortality due to malignant melanoma in Ecuador significantly increased over the 17-year study period; the spatial analysis and spatial autocorrelation indicates the presence of high-risk occurrence clusters in the Highlands region of the country.
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Affiliation(s)
- Solange Núñez-González
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Estefania Bedoya
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Christopher Gault
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
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18
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Loria D, Abriata MG, Santoro F, Latorre C. Cutaneous melanoma in Argentina: an analysis of its characteristics and regional differences. Ecancermedicalscience 2020; 14:1017. [PMID: 32256700 PMCID: PMC7105344 DOI: 10.3332/ecancer.2020.1017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose This study aims to increase the knowledge about the characteristics of cutaneous melanoma in Argentina, their association with the risk of having Breslow ≥1 mm and mortality trends for the period 2002-2017. Patients and methods Descriptive statistics and regression analyses were done for 10.199 cases within the Argentine Melanoma Registry in the period 2002-2018. Trends in age-standardised mortality rates (ASMR) were analysed using the Join point Regression Model. Results Cases showed lesions mainly located in males' trunk (37%) and in females' lower limbs (29%). The level of invasion was higher in males who also showed higher mortality. Cases from the North West and North East regions showed a major risk of Breslow >1 mm and harboured CM in lower limbs more frequently than in other regions. Nearly, 25% of tumours over 2 mm were in cases aged <50 years and 37.6% in patients ≥50 years. In the North West, North East and Patagonia, the frequency of cases in young people was higher than in older people. In 43% of cases, the melanoma subtype was not specified in the report. The number of superficial spreading melanomas, the most common histology, was nearly twice that of Nodular melanomas the following histology in importance (3,403 and 1,754, respectively). Melanoma mortality rates in all Argentine population increased in the elderly. Lower melanoma mortality rates were observed in the North West. In 2007-2017, ASMR decreased significantly in females (average 1.4% p/year) while it increased nonsignificantly in males (0.4% p/year).The tumours with the worst prognosis were associated with the elderly, males, nodular or acrolentiginous morphologies, residing somewhere other than Centro and Patagonia and with tumors located in the head/neck and legs. Conclusion The geographical variations found for melanoma characteristics and their mortality in Argentina, makes it imperative that epidemiological research is continued to avoid generalisations and improve future preventive actions.
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Affiliation(s)
- Dora Loria
- Argentine Registry of Cutaneous Melanoma, Av Callao 852, C1025 CABA, Argentina
| | | | - Federico Santoro
- Fellow of Epidemiology, National Ministry of Health, Av 9 de Julio 1925, C1072 CABA, Argentina
| | - Clara Latorre
- Argentine Registry of Cutaneous Melanoma, Av Callao 852, C1025 CABA, Argentina
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19
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Pozzobon FC, Acosta AE. Epidemiological profile of primary cutaneous melanoma over a 15-year period at a private skin cancer center in Colombia. ACTA ACUST UNITED AC 2019; 20:226-231. [PMID: 30570006 DOI: 10.15446/rsap.v20n2.65616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 01/08/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe clinical, histopathological and treatment characteristics of melanoma in a private institution of Bogotá, Colombia, and to identify differences regarding sex and age. MATERIALS AND METHODS Observational, retrospective study. 415 medical records between January 1999 and May 2014 were analyzed. RESULTS Out of 415 patients, 244 (58.8%) were females and 171 (41.2%) were males with a mean age of 56.1 ±16.2 SD. Superficial spreading melanoma (SSMM) was the main subtype (n=175, 42.7%). Breslow's thickness ≤1mm was predominant, while phototypes II and III were more frequent (n=87, 69.6%). Melanoma was predominantly localized on the head in men (n=83, 50.3%) and in the lower limbs in women (n=89, 36.8%), with a higher frequency of SSMM pattern among patients aged ≤65. Lentigo maligna (LM) was more frequent in patients aged >65 (p<0.001), with a higher number of ulcerated melanomas (p=0.046). CONCLUSIONS A predominance of thin SSMM and fair skin phototypes were found, unlike previous reports that showed acral lentiginous melanoma (ALM) as predominant, which may be caused by local variations related to mixed ethnicity.
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Affiliation(s)
- Flavia C Pozzobon
- FP: MD. M. Sc. Dermatologist Universidad Nacional de Colombia. Universidad de Barcelona. Instituto Nacional de Cancerología. Bogotá, Colombia.
| | - Alvaro Enrique Acosta
- AA: MD. Oncologist Dermatologist Universidad Nacional de Colombia, Universidad Javeriana. Instituto Nacional de Cancerología. Bogotá, Colombia.
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20
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Lucas RM, Yazar S, Young AR, Norval M, de Gruijl FR, Takizawa Y, Rhodes LE, Sinclair CA, Neale RE. Human health in relation to exposure to solar ultraviolet radiation under changing stratospheric ozone and climate. Photochem Photobiol Sci 2019; 18:641-680. [PMID: 30810559 DOI: 10.1039/c8pp90060d] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Montreal Protocol has limited increases in the UV-B (280-315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Nevertheless, the incidence of skin cancers continues to increase in most light-skinned populations, probably due mainly to risky sun exposure behaviour. In locations with strong sun protection programs of long duration, incidence is now reducing in younger age groups. Changes in the epidemiology of UV-induced eye diseases are less clear, due to a lack of data. Exposure to UV radiation plays a role in the development of cataracts, pterygium and possibly age-related macular degeneration; these are major causes of visual impairment world-wide. Photodermatoses and phototoxic reactions to drugs are not uncommon; management of the latter includes recognition of the risks by the prescribing physician. Exposure to UV radiation has benefits for health through the production of vitamin D in the skin and modulation of immune function. The latter has benefits for skin diseases such as psoriasis and possibly for systemic autoimmune diseases such as multiple sclerosis. The health risks of sun exposure can be mitigated through appropriate sun protection, such as clothing with both good UV-blocking characteristics and adequate skin coverage, sunglasses, shade, and sunscreen. New sunscreen preparations provide protection against a broader spectrum of solar radiation, but it is not clear that this has benefits for health. Gaps in knowledge make it difficult to derive evidence-based sun protection advice that balances the risks and benefits of sun exposure.
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Affiliation(s)
- R M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia. and Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - S Yazar
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia and MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - M Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - F R de Gruijl
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Y Takizawa
- Akita University School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - L E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - R E Neale
- QIMR Berghofer Institute of Medical Research, Herston, Brisbane, Australia and School of Public Health, University of Queensland, Australia
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21
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Arnold M, de Vries E, Whiteman DC, Jemal A, Bray F, Parkin DM, Soerjomataram I. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int J Cancer 2018; 143:1305-1314. [PMID: 29659012 DOI: 10.1002/ijc.31527] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/09/2018] [Accepted: 03/13/2018] [Indexed: 12/21/2022]
Abstract
Ultraviolet radiation (UVR) is a strong and ubiquitous risk factor for cutaneous melanoma, emitted naturally by the sun but also artificial sources. To shed light on the potential impact of interventions seeking to reduce exposure to UVR in both high and low risk populations, we quantified the number of cutaneous melanomas attributable to UVR worldwide. Population attributable fractions and numbers of new melanoma cases in adults due to ambient UVR were calculated by age and sex for 153 countries by comparing the current melanoma burden with historical data, i.e., the melanoma burden observed in a population with minimal exposure to UVR. Secondary analyses were performed using contemporary melanoma incidence rates in dark-skinned African populations with low UVR susceptibility as reference. Globally, an estimated 168,000 new melanoma cases were attributable to excess UVR in 2012, corresponding to 75.7% of all new melanoma cases and 1.2% of all new cancer cases. This burden was concentrated in very highly developed countries with 149,000 attributable cases and was most pronounced in Oceania, where 96% of all melanomas (representing 9.3% of the total cancer burden) were attributable to excess UVR. There would be approximately 151,000 fewer melanoma cases worldwide were incidence rates in every population equivalent to those observed in selected low-risk (dark-skinned, heavily pigmented) reference populations. These findings underline the need for public health action, an increasing awareness of melanoma and its risk factors, and the need to promote changes in behavior that decrease sun exposure at all ages.
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Affiliation(s)
- Melina Arnold
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, Lyon, France
| | - Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - David C Whiteman
- Cancer Control Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | | | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, Lyon, France
| | - Donald Maxwell Parkin
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, Lyon, France
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22
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Bais F, Luca RM, Bornman JF, Williamson CE, Sulzberger B, Austin AT, Wilson SR, Andrady AL, Bernhard G, McKenzie RL, Aucamp PJ, Madronich S, Neale RE, Yazar S, Young AR, de Gruijl FR, Norval M, Takizawa Y, Barnes PW, Robson TM, Robinson SA, Ballaré CL, Flint SD, Neale PJ, Hylander S, Rose KC, Wängberg SÅ, Häder DP, Worrest RC, Zepp RG, Paul ND, Cory RM, Solomon KR, Longstreth J, Pandey KK, Redhwi HH, Torikai A, Heikkilä AM. Environmental effects of ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2017. Photochem Photobiol Sci 2018; 17:127-179. [PMID: 29404558 PMCID: PMC6155474 DOI: 10.1039/c7pp90043k] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 12/11/2022]
Abstract
The Environmental Effects Assessment Panel (EEAP) is one of three Panels of experts that inform the Parties to the Montreal Protocol. The EEAP focuses on the effects of UV radiation on human health, terrestrial and aquatic ecosystems, air quality, and materials, as well as on the interactive effects of UV radiation and global climate change. When considering the effects of climate change, it has become clear that processes resulting in changes in stratospheric ozone are more complex than previously held. Because of the Montreal Protocol, there are now indications of the beginnings of a recovery of stratospheric ozone, although the time required to reach levels like those before the 1960s is still uncertain, particularly as the effects of stratospheric ozone on climate change and vice versa, are not yet fully understood. Some regions will likely receive enhanced levels of UV radiation, while other areas will likely experience a reduction in UV radiation as ozone- and climate-driven changes affect the amounts of UV radiation reaching the Earth's surface. Like the other Panels, the EEAP produces detailed Quadrennial Reports every four years; the most recent was published as a series of seven papers in 2015 (Photochem. Photobiol. Sci., 2015, 14, 1-184). In the years in between, the EEAP produces less detailed and shorter Update Reports of recent and relevant scientific findings. The most recent of these was for 2016 (Photochem. Photobiol. Sci., 2017, 16, 107-145). The present 2017 Update Report assesses some of the highlights and new insights about the interactive nature of the direct and indirect effects of UV radiation, atmospheric processes, and climate change. A full 2018 Quadrennial Assessment, will be made available in 2018/2019.
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Affiliation(s)
- F. Bais
- Aristotle Univ. of Thessaloniki, Laboratory of Atmospheric Physics, Thessaloniki, Greece
| | - R. M. Luca
- National Centre for Epidemiology and Population Health, Australian National Univ., Canberra, Australia
| | - J. F. Bornman
- Curtin Univ., Curtin Business School, Perth, Australia
| | | | - B. Sulzberger
- Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - A. T. Austin
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. R. Wilson
- School of Chemistry, Centre for Atmospheric Chemistry, Univ. of Wollongong, Wollongong, Australia
| | - A. L. Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State Univ., Raleigh, NC, USA
| | - G. Bernhard
- Biospherical Instruments Inc., San Diego, CA, USA
| | | | - P. J. Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - S. Madronich
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | - R. E. Neale
- Queensland Institute of Medical Research, Royal Brisbane Hospital, Brisbane, Australia
| | - S. Yazar
- Univ. of Western Australia, Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, Australia
| | | | - F. R. de Gruijl
- Department of Dermatology, Leiden Univ. Medical Centre, Leiden, The Netherlands
| | - M. Norval
- Univ. of Edinburgh Medical School, UK
| | - Y. Takizawa
- Akita Univ. School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - P. W. Barnes
- Department of Biological Sciences and Environment Program, Loyola Univ., New Orleans, USA
| | - T. M. Robson
- Research Programme in Organismal and Evolutionary Biology, Viikki Plant Science Centre, Univ. of Helsinki, Finland
| | - S. A. Robinson
- Centre for Sustainable Ecosystem Solutions, School of Biological Sciences, Univ. of Wollongong, Wollongong, NSW 2522, Australia
| | - C. L. Ballaré
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. D. Flint
- Dept of Forest, Rangeland and Fire Sciences, Univ. of Idaho, Moscow, ID, USA
| | - P. J. Neale
- Smithsonian Environmental Research Center, Edgewater, Maryland, USA
| | - S. Hylander
- Centre for Ecology and Evolution in Microbial model Systems, Linnaeus Univ., Kalmar, Sweden
| | - K. C. Rose
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - S.-Å. Wängberg
- Dept Marine Sciences, Univ. of Gothenburg, Göteborg, Sweden
| | - D.-P. Häder
- Friedrich-Alexander Univ. Erlangen-Nürnberg, Dept of Biology, Möhrendorf, Germany
| | - R. C. Worrest
- CIESIN, Columbia Univ., New Hartford, Connecticut, USA
| | - R. G. Zepp
- United States Environmental Protection Agency, Athens, Georgia, USA
| | - N. D. Paul
- Lanter Environment Centre, Lanter Univ., LA1 4YQ, UK
| | - R. M. Cory
- Earth and Environmental Sciences, Univ. of Michigan, Ann Arbor, MI, USA
| | - K. R. Solomon
- Centre for Toxicology, School of Environmental Sciences, Univ. of Guelph, Guelph, ON, Canada
| | - J. Longstreth
- The Institute for Global Risk Research, Bethesda, MD, USA
| | - K. K. Pandey
- Institute of Wood Science and Technology, Bengaluru, India
| | - H. H. Redhwi
- Chemical Engineering Dept, King Fahd Univ. of Petroleum and Minerals, Dhahran, Saudi Arabia
| | - A. Torikai
- Materials Life Society of Japan, Kayabacho Chuo-ku, Tokyo, Japan
| | - A. M. Heikkilä
- Finnish Meteorological Institute R&D/Climate Research, Helsinki, Finland
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23
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Reyes E, Uribe C, de Vries E. Population-based incidence and melanoma-specific survival of cutaneous malignant melanoma in a Colombian population 2000-2009. Int J Dermatol 2017; 57:21-27. [PMID: 29231241 DOI: 10.1111/ijd.13839] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/13/2017] [Accepted: 10/18/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Demographic, clinical, and morphological characteristics of cutaneous melanoma are unknown for the Colombian population. We aim to provide these characteristics as well as population-based incidence and survival data. METHODS All patients with an invasive cutaneous melanoma diagnosed in the period 2000-2009 registered in the population-based cancer registry of the metropolitan area of Bucaramanga were included for analysis (n = 169). Age-standardized incidence rates were calculated and melanoma-specific and overall survival estimated with follow-up until June 9, 2016, using Kaplan-Meier methodology, stratifying for gender, anatomical localization, and type of affiliation to the social security system. RESULTS The age-standardized melanoma incidence rate was 1.7 per 100,000, with lower limbs being the most affected body sites (42.6% of all melanomas). A high proportion of melanomas presented on the plants or palms (16%) and under the nails (7.1%); at least 24.3% of melanomas were ulcerated, and 21.1% had a Breslow thickness more than 2 mm. Melanoma-specific 5-year survival was 79.3%, with worst survival for melanomas localized on the plants (64.6%) and subungual areas (55.6%). Affiliation to the subsidized type of affiliation to the social security system was statistically significantly (P = 0.003) associated with poorer survival (68.8%) compared to the special regimes (95.8%). CONCLUSIONS Melanoma is a relatively rare cancer in Colombia with mainly the acral sites, high proportion of thick and ulcerated melanomas, and relatively poor survival being distinct features, indicating the need for tailor-made primary and secondary prevention strategies. Better training of pathologists in the difficult field of melanoma would improve precision of available data.
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Affiliation(s)
- Evy Reyes
- Grupo de Estudio Genético de Enfermedades Complejas, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia
| | - Claudia Uribe
- Grupo de Estudio Genético de Enfermedades Complejas, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia
| | - Esther de Vries
- Departamento de Epidemiología Clínica y Bioestadística, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Cundinamarca, Colombia
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24
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Miller KA, In GK, Jiang SY, Ahadiat O, Higgins S, Wysong A, Cockburn MG. Skin Cancer Prevention Among Hispanics: a Review of the Literature. CURRENT DERMATOLOGY REPORTS 2017. [DOI: 10.1007/s13671-017-0191-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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25
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de Vries E, Amador JR, Rincon CJ, Uribe C, Parkin DM. Cutaneous melanoma attributable to solar radiation in Cali, Colombia. Int J Cancer 2017; 140:2070-2074. [PMID: 28187531 DOI: 10.1002/ijc.30638] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 12/16/2023]
Abstract
Estimating the population attributable fraction (PAF) of melanomas due to sun exposure is challenging as there are no unexposed population nor reliable exposure data. In high incidence countries, a historic cohort of the South Thames cancer registry was used as a minimally exposed population using the formula PAF = (observed incidence-incidence in minimally exposure)/observed incidence. In this study, we apply this method, constructing a minimally exposed cohort for Colombia and also using the historical South Thames data, using melanoma incidence data from the population-based cancer registry of Cali, Colombia for the period 1967-2012. The historic cohort incidence rates were very similar to those of Thames, but cohort effects were smaller for women and nonexistent for men. Age-specific incidence rates of these minimally exposed cohorts were applied to recent population numbers. For females, PAFs were 19% using the historic Thames cohort and 25% using the historic Cali cohort, corresponding numbers for males were 62% (vs. Thames) and 0% (vs. Cali). Taking into account the incidence rates of acral melanomas, which are not sun related, the PAF increased in women to 26% (vs. Thames) and 34% (vs. Cali) and for men 77% (vs. Thames). This exercise shows the modest contribution of exposure to ultraviolet radiation in the burden of melanoma in low-incidence countries, as well as the importance to take into consideration the acral lentiginous melanomas.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Julio R Amador
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
- Department of Dermatology, Hospital Militar Central de Colombia, Bogota, Colombia
| | - Carlos Javier Rincon
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Claudia Uribe
- Grupo de Estudio Genético de Enfermedades Complejas, Universidad Autónoma de Bucaramanga, Colombia
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