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Mattila KE, Vihinen H, Heervä E, Nuotio MS, Vihinen P. The impact of prognostic factors and comorbidities on survival in older adults with stage I - III cutaneous melanoma in Southwest Finland: A register study. J Geriatr Oncol 2024; 15:101701. [PMID: 38219332 DOI: 10.1016/j.jgo.2023.101701] [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: 09/13/2023] [Revised: 11/23/2023] [Accepted: 12/22/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Despite being diagnosed with thicker and more often ulcerated melanomas, cancer-specific survival (CSS) is not necessarily inferior in older adults with melanoma compared to younger patients. MATERIALS AND METHODS Our aim was to evaluate the impact of baseline melanoma-specific prognostic factors and comorbidities on recurrence-free survival (RFS), CSS, and overall survival (OS) in patients aged 70-79 (n = 474) and ≥ 80 years (n = 286) with resected stage I - III cutaneous melanoma in Southwest Finland between January 1, 2000 and December 31, 2020. Patients were restaged according to the 8th edition of TNM classification, and comorbidities were assessed using the Charlson Comorbidity Index (CCI). RESULTS Patients aged ≥80 years had thicker and more commonly ulcerated melanomas: 43.0%, 40.9%, and 16.1% of patients aged ≥80 and 56.5%, 25.3%, and 18.1% of patients aged 70-79 years were diagnosed with stage I, II, and III melanoma, respectively. Multiple comorbidities (CCI ≥2) were more common and sentinel lymph node biopsy less frequently performed in patients aged ≥80 years. RFS and CSS were similar in patients aged 70-79 years and ≥ 80 years: median RFS 13.8 years vs not reached, with the hazard ratio of melanoma recurrence or death from melanoma 1.25 (95% confidence interval [CI]: 0.91-1.71); median CSS was not reached, with the hazard ratio of death from melanoma 1.12 (95%CI: 0.81-1.75). The proportion of patients who were alive with melanoma recurrence or had died from melanoma was similar in both age groups. In multivariable analysis, higher pathological stage was the only independent risk factor for short RFS regardless of age group, sex, CCI, and tumor ulceration. Higher stage and male sex were associated with short CSS. Age ≥ 80 years, stage III disease, and CCI ≥ 2 were associated with short OS and female sex with long OS in multivariable analysis. DISCUSSION Pathological stage was the most influential factor determining RFS and CSS in older adults with resected stage I - III melanoma. Concerning OS, age ≥ 80 years, stage III disease, and multiple comorbidities had a significant negative impact.
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Affiliation(s)
- Kalle E Mattila
- Department of Oncology, Fican West Cancer Centre, University of Turku and Turku University Hospital, Finland; InFLAMES Research Flagship Center, University of Turku, Finland.
| | - Helmi Vihinen
- Department of Oncology, Fican West Cancer Centre, University of Turku and Turku University Hospital, Finland; Turku School of Economics, University of Turku, Finland
| | - Eetu Heervä
- InFLAMES Research Flagship Center, University of Turku, Finland
| | - Maria S Nuotio
- Department of Geriatric Medicine, University of Turku and Turku University Hospital, Finland
| | - Pia Vihinen
- Department of Oncology, Fican West Cancer Centre, University of Turku and Turku University Hospital, Finland
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Bainvoll L, Mandelbaum RS, Worswick SD, Matsuo K. Anatomical location of melanoma: A gender-specific analysis. J Surg Oncol 2023; 127:203-206. [PMID: 36173039 DOI: 10.1002/jso.27111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/30/2022] [Accepted: 09/07/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Liat Bainvoll
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA.,Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Rachel S Mandelbaum
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
| | - Scott D Worswick
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
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Risk of Cardiovascular Disease Death in Older Malignant Melanoma Patients: A Population-Based Study. Cancers (Basel) 2022; 14:cancers14194783. [PMID: 36230706 PMCID: PMC9563114 DOI: 10.3390/cancers14194783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 12/02/2022] Open
Abstract
Noncancer deaths account for a large proportion of deaths in patients with malignant melanoma (MM), but the risk of cardiovascular disease (CVD) death in older MM patients remains unclear. This study aimed to estimate the risk of CVD death in older MM patients. Data on older MM patients were obtained in the Surveillance, Epidemiology, and End Results database. Risk of CVD death was calculated by standardized mortality rates (SMRs), cumulative mortality and proportion of different causes of death. MM patients had a higher risk of CVD death than general populations (SMR = 1.98; 95% CI 1.93−2.03, p < 0.001). CVD death was more common in MM patients who were diagnosed at age 85 or older, had a localized stage, were white, had surgical treatment, had a primary head/neck/upper limb site and had a low-grade and superficial spreading/lentigo malignant pathologic type. Cumulative CVD mortality was more common than primary cancer in all older age groups, male or female, and patients with localized-stage disease. Other than primary cancer, CVD was the main cause of death in older patients diagnosed with MM. Our findings highlight CVD death is an important competing event of deaths in older MM patients, and more attention should be paid to reducing CVD death to improve survival.
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Risk factors for cardiovascular mortality and melanoma-specific mortality among patients with melanoma: a SEER based study. Eur J Cancer Prev 2022; 31:293-300. [PMID: 34010239 DOI: 10.1097/cej.0000000000000690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE This study aims to identify the risk factors for cardiovascular mortality in melanoma patients. METHODS Data of melanoma patients were obtained from the Surveillance, Epidemiology, and End Results database. We used Person's chi-square test to assess the relationships between categorical variables. We used Kaplan-Meier test in the univariate analysis and Cox regression test for the multivariate analysis. Analyses were conducted using the SPSS software. RESULTS We analyzed data of 194 503 melanoma patients. Among them, 28 818 (14.8 %) died due to cardiovascular diseases. Cardiovascular-specific survival was higher in younger patients, women, married, localized disease, superficial spreading melanoma and in patients who had surgery. It was lower in patients who received chemotherapy or radiotherapy. The multivariate analysis revealed a higher risk of cardiovascular mortality in patients aged 50-64 years [hazard ratio (HR), 7.297; 95% confidence interval (CI), 6.68-7.97], patients aged ≥65 years (HR, 43.309; 95% CI, 39.706-47.240), men (HR, 1.535; 95% CI, 1.475-1.597), Blacks (HR, 1.29; 95% CI, 1.044-1.594), separated (HR, 1.286; 95% CI, 1.058-1.562), widowed (HR, 1.829; 95% CI, 1.706-1.961), patients with no or unknown history of chemotherapy (HR, 1.302; 95% CI, 1.071-1.583) or radiotherapy (HR, 1.477; 95% CI, 1.217-1.793) and patients with no surgery (HR, 1.468; 95% CI, 1.264-1.706). CONCLUSIONS In patients with melanoma, the risk of cardiovascular death is higher in older patients, men, Blacks, separated, widowed and patients with nodular or lentigo maligna melanoma. The risk is lower in married, patients with superficial spreading or acral lentiginous melanoma, and patients who had chemotherapy, radiotherapy or surgery.
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Castro E Souza BD, Morais Silva DH, Valente NYS, Kakizaki P, Luce MCA, Bandeira LG. Cutaneous melanoma: a retrospective study of 18 years. Are there gender differences? An Bras Dermatol 2021; 96:619-623. [PMID: 34284941 PMCID: PMC8441497 DOI: 10.1016/j.abd.2020.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/20/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Bruno de Castro E Souza
- Department of Dermatology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil
| | | | | | - Priscila Kakizaki
- Department of Dermatology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil
| | - Maria Claudia Alves Luce
- Department of Dermatology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil
| | - Luiza Groba Bandeira
- Department of Dermatology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil
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Di Carlo V, Estève J, Johnson C, Girardi F, Weir HK, Wilson RJ, Minicozzi P, Cress RD, Lynch CF, Pawlish KS, Rees JR, Coleman MP, Allemani C. Trends in short-term survival from distant-stage cutaneous melanoma in the United States, 2001-2013 (CONCORD-3). JNCI Cancer Spectr 2021; 4:pkaa078. [PMID: 33409455 PMCID: PMC7771008 DOI: 10.1093/jncics/pkaa078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/13/2020] [Accepted: 08/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background Survival from metastatic cutaneous melanoma is substantially lower than for localized disease. Treatments for metastatic melanoma have been limited, but remarkable clinical improvements have been reported in clinical trials in the last decade. We described the characteristics of US patients diagnosed with cutaneous melanoma during 2001-2013 and assessed trends in short-term survival for distant-stage disease. Methods Trends in 1-year net survival were estimated using the Pohar Perme estimator, controlling for background mortality with life tables of all-cause mortality rates by county of residence, single year of age, sex, and race for each year 2001-2013. We fitted a flexible parametric survival model on the log-hazard scale to estimate the effect of race on the hazard of death because of melanoma and estimated 1-year net survival by race. Results Only 4.4% of the 425 915 melanomas were diagnosed at a distant stage, cases diagnosed at a distant stage are more commonly men, older patients, and African Americans. Age-standardized, 1-year net survival for distant-stage disease was stable at approximately 43% during 2001-2010. From 2010 onward, survival improved rapidly, reaching 58.9% (95% confidence interval = 56.6% to 61.2%) for patients diagnosed in 2013. Younger patients experienced the largest improvement. Survival for distant-stage disease increased in both Blacks and Whites but was consistently lower in Blacks. Conclusions One-year survival for distant-stage melanoma improved during 2001-2013, particularly in younger patients and those diagnosed since 2010. This improvement may be a consequence of the introduction of immune-checkpoint-inhibitors and other targeted treatments for metastatic and unresectable disease. Persistent survival inequalities exist between Blacks and Whites, suggesting differential access to treatment.
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Affiliation(s)
- Veronica Di Carlo
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jacques Estève
- Université Claude Bernard, Hospices Civils de Lyon, Service de Biostatistique, Lyon Cedex 03, France
| | | | - Fabio Girardi
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Hannah K Weir
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Reda J Wilson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pamela Minicozzi
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Rosemary D Cress
- Public Health Institute, Cancer Registry of Greater California, Sacramento, CA, USA
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | | | - Judith R Rees
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Michel P Coleman
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Mo R, Chen C, Jiang Y, Ma Z, Meng X, Tan Q. Sex-specific survival benefit in early skin melanoma based on 8th AJCC edition: an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:53. [PMID: 33553346 PMCID: PMC7859735 DOI: 10.21037/atm-20-3845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Females have been found to have a survival benefit over males in past studies. However, in early melanoma patients, this benefit occurred in only those aged >60 years. The 8th edition of the American Joint Committee on Cancer (AJCC) readjusted the melanoma staging system, specifically stage I. This study aims to verify whether the sex-specific benefit in females exists in different age groups according to the 8th edition of the staging system. Methods We collected the data of individuals diagnosed with skin melanoma between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Based on the 8th edition of the melanoma staging system, patients diagnosed with pathological stage T1a-T3a, N0 and M0 melanoma were enrolled. Results A total of 115,576 patients, including 62,938 male patients and 52,638 female patients, were enrolled in this study. The survival rates of males and females in each stage from IA–IIA were significantly different (P<0.001). In further analyses of each age group, it was found that the proportions of patients with stages IA, IB and IIA were significantly different in each age group. Cox analysis showed that females with stage IA in all age groups benefited significantly, but those in stage IB benefited only when they were aged >60 years. In stage IIA patients, there were significant differences between the <50 and 61–70 years age groups. Conclusions Based on data from the SEER database, we found that according to the 8th edition of the AJCC melanoma staging system, females had a higher survival rate than males, and this difference was significant in all age groups in the stage IA group but fluctuated with age in the stage IB and IIA groups.
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Affiliation(s)
- Ran Mo
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.,Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing, China
| | - Chen Chen
- Department of Nutrition, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing, China
| | - Yanan Jiang
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing, China
| | - Zhouji Ma
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Xueyong Meng
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing, China
| | - Qian Tan
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.,Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University, Nanjing, China
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Tometich DB, Hyland KA, Soliman H, Jim HSL, Oswald L. Living with Metastatic Cancer: A Roadmap for Future Research. Cancers (Basel) 2020; 12:E3684. [PMID: 33302472 PMCID: PMC7763639 DOI: 10.3390/cancers12123684] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 02/06/2023] Open
Abstract
Living with metastatic cancer, or metavivorship, differs from cancer survivorship and has changed as novel treatments have increased survival time. The purpose of this narrative review is to describe factors that impact challenges in metavivorship within a conceptual framework to guide future research. This review focuses on the specific metavivorship outcomes of progressive disease, survival time, symptoms, distress, financial toxicity, and quality of life. We describe the predisposing, precipitating, and perpetuating (3P) model of metavivorship. Understanding the biological, psychological, and social 3P factors that contribute to the development and maintenance of challenges in metavivorship provides a roadmap for future research. Implications of this model include prevention by targeting predisposing factors, management of precipitating factors after onset of metastatic disease, and treatment of perpetuating factors to reduce symptoms and improve quality of life during the chronic phase of metavivorship. This can be accomplished through biopsychosocial screening efforts, monitoring of patient-reported outcomes, education and communication interventions, interdisciplinary symptom management, advance care planning, and behavioral interventions to cultivate psychological resilience.
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Affiliation(s)
- Danielle B. Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (D.B.T.); (H.S.L.J.)
| | - Kelly A. Hyland
- Department of Psychology, University of South Florida, Tampa, FL 33612, USA;
| | - Hatem Soliman
- Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (D.B.T.); (H.S.L.J.)
| | - Laura Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA; (D.B.T.); (H.S.L.J.)
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9
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Souza BDCE, Silva DHM, Miyashiro D, Kakizaki P, Valente NYS. Clinicopathological analysis of acral melanoma in a single center: a study of 45 cases. Rev Assoc Med Bras (1992) 2020; 66:1391-1395. [PMID: 33174932 DOI: 10.1590/1806-9282.66.10.1391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/21/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The relationship between the clinicopathological and sociodemographics characteristics of acral melanomas diagnosed at the Hospital do Servidor Público Estadual de São Paulo was analyzed and traced between 1997 and 2016. METHODS An observational, descriptive, and retrospective study of patients diagnosed with acral melanoma was performed at Hospital do Servidor Público Estadual de São Paulo. Sociodemographic and clinicopathological characteristics were collected and analyzed. RESULTS Forty-five patients with acral melanomas were found during the evaluation period. Thirty-one were females, and 14 were males (68.89% and 31.3%, respectively). Most of the cases were invasive (88.37%), and the predominant histological subtype was the acral lentiginous (91.11%). The plantar region was the most prevalent (64.44%). The median Breslow index was 3 mm, and there was a tendency towards greater severity in male patients. CONCLUSIONS Acral site melanomas are detected diagnosed when they reach more advanced stages, which leads to a worse prognosis for patients. Late detection assumes even greater importance in highly mixed and black populations, such as the Brazilian population.
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Affiliation(s)
- Bruno de Castro E Souza
- Médico Dermatologista - Departamento de Dermatologia do Hospital das Clínicas da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Diego Henrique Morais Silva
- Médico Residente - Médico Residente do Departamento de Dermatologia do Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brasil
| | - Denis Miyashiro
- Médico Dermatologista Preceptor da Dermatologia do Hospital das Clínicas da Universidade de São Paulo - Departamento de Dermatologia do Hospital das Clínicas da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Priscila Kakizaki
- Médica Dermatologia Preceptora do Hospital do Servidor Público Estadual de São Paulo - Departamento de Dermatologia do Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brasil
| | - Neusa Yuriko Sakai Valente
- Doutora em Dermatologia - Departamento de Dermatologia no Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brasil
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Mo R, Chen C, Mi L, Ma Z, Tan Q. Skin melanoma survival is not superior in females in the new stage IIID of the 8th edition of the staging system: an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1381. [PMID: 33313126 PMCID: PMC7723544 DOI: 10.21037/atm-20-3332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background In the 8th edition of the melanoma staging system, stage III was divided into stages IIIA-IIID. Previous studies have found that the long-term survival rate of females is much higher than that of males. This study was designed to explore whether this sex-specific advantage still exists in the new staging subgroups. Methods We obtained data from individuals diagnosed with skin melanoma between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. A total of 8,726 patients with stage III disease were enrolled in the study (5,370 males and 3,356 females). Among these patients, 505 had stage IIID disease (370 males and 135 females). Results In the 7th edition of the staging system, there were significant sex-specific differences in overall survival (OS) and melanoma-specific survival (MSS) in each subgroup of stage III. In stages IIIA-IIIC in the 8th edition, there were also significant differences between males and females (P<0.001), but in stage IIID patients, there were no significant differences in either OS (P=0.312) or MSS (P=0.288). Cox analysis confirmed that stage IIID does not affect prognosis in males. Further research found no difference between males and females with stage IIID disease in any age subgroup. Conclusions We compared sex-specific survival differences in patients with stage III disease according to the 8th edition of the staging system. Females with stage IIIA-IIIC disease have better survival rates than males. However, among patients with stage IIID disease, there is no significant difference in survival between males and females.
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Affiliation(s)
- Ran Mo
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.,Department of Burns & Plastic Surgery, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Chen Chen
- Department of Nutrition, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Lin Mi
- Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhouji Ma
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Qian Tan
- Department of Burns & Plastic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.,Department of Burns & Plastic Surgery, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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Mancini S, Crocetti E, Bucchi L, Pimpinelli N, Vattiato R, Giuliani O, Ravaioli A, Baldacchini F, Stanganelli I, Falcini F. Time trends and age-period-cohort analysis of cutaneous malignant melanoma incidence rates in the Romagna Region (northern Italy), 1986-2014. Melanoma Res 2020; 30:198-205. [PMID: 30615011 DOI: 10.1097/cmr.0000000000000570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
After a long-term increase, the incidence of cutaneous malignant melanoma has stabilized recently or even decreased in several populations of North-western Europe, USA, Canada, Australia and New Zealand, but not in southern Europe. The incidence trends of primary invasive cutaneous malignant melanoma (International Classification of Diseases, 10th revision, codes C43.0-C43.9) in the Romagna Region (northern Italy, 1.2 million inhabitants) for the period 1986-2014 were analysed with an age-period-cohort modelling approach. The series included 2466 men and 2481 women, a total of 4947 patients. Using the method of model building, the best-fitting models were found to be an age-drift model for men and an age-period model for women. Among men, the age-specific incidence rates increased in each successive cohort born between 1916 and 1981 with an attenuation of the trend for younger ones in the last cohorts. Among younger women, a slight decrease occurred for the cohorts born after 1961. For men, the quasi-parallel appearance of incidence curves by age group and cohort on a log scale suggested that the observed change was explained by a linear cohort effect. For women, the curves tended to overlap, suggesting an interaction between age and cohort that could be explained as a nonlinear period effect. In conclusion, the long-term upward incidence trend in the study area is stabilizing among women and an attenuation of the increasing trend is occurring among younger men in the most recent cohorts. These observations need to be confirmed with longer-term studies.
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Affiliation(s)
- Silvia Mancini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Emanuele Crocetti
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Lauro Bucchi
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Nicola Pimpinelli
- Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence Medical School, Florence, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
- University of Parma, Parma
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
- Romagna Local Health Authority, Forlì, Italy
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Hieken TJ, Glasgow AE, Enninga EAL, Kottschade LA, Dronca RS, Markovic SN, Block MS, Habermann EB. Sex-Based Differences in Melanoma Survival in a Contemporary Patient Cohort. J Womens Health (Larchmt) 2020; 29:1160-1167. [PMID: 32105561 DOI: 10.1089/jwh.2019.7851] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: A female survival advantage in cutaneous melanoma has been long recognized. However, whether this extends across all age groups, with risk stratification using the latest prognostic staging system or in the current era of efficacious systemic therapies is unknown. Therefore, we evaluated whether sex-based differences in melanoma survival persisted within a recent population-based patient cohort with consideration of these factors. Materials and Methods: We identified stage II-IV cutaneous melanoma patients from 2010 to 2014 Surveillance, Epidemiology, and End Results cancer registries data. We recalculated stage per American Joint Committee on Cancer 8th edition guidelines. Cancer-specific survival (CSS) was estimated by using the Kaplan-Meier method and multivariable Cox proportional hazards regression. Results: Of 16,807 patients (39.8% female), 8,990 were stage II, 4,826 stage III, and 2,991 stage IV at diagnosis. Unadjusted 3-/5-year CSS estimates for females versus males were 64.2% versus 59.7%, and 53.5% versus 49.9%, respectively, p ≤ 0.0001. Five-year CSS varied within each stage and across age strata of <45, 45 - 59, and ≥60 years. Within each stage, females <45 had better CSS than all other sex/age groups (p < 0.0001). In multivariable analysis of stage II/III patients, female sex, younger age, and lower mitotic index retained favorable CSS prognostic significance (p < 0.001). Conclusions: Sex-based differences in melanoma survival persist in a contemporary patient cohort staged with the latest prognostic system. These data may guide decision marking regarding adjuvant therapy, highlight the importance of including sex as a pre-specified clinical trial variable, and suggest that investigation of underlying biologic mechanisms may drive discovery of biomarkers and therapeutic targets to improve patient care.
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Affiliation(s)
- Tina J Hieken
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Amy E Glasgow
- Department of Robert D. and Patricia E. Kern for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Roxana S Dronca
- Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Matthew S Block
- Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth B Habermann
- Department of Robert D. and Patricia E. Kern for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
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Abstract
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2016) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2017) were collected by the National Center for Health Statistics. In 2020, 1,806,590 new cancer cases and 606,520 cancer deaths are projected to occur in the United States. The cancer death rate rose until 1991, then fell continuously through 2017, resulting in an overall decline of 29% that translates into an estimated 2.9 million fewer cancer deaths than would have occurred if peak rates had persisted. This progress is driven by long-term declines in death rates for the 4 leading cancers (lung, colorectal, breast, prostate); however, over the past decade (2008-2017), reductions slowed for female breast and colorectal cancers, and halted for prostate cancer. In contrast, declines accelerated for lung cancer, from 3% annually during 2008 through 2013 to 5% during 2013 through 2017 in men and from 2% to almost 4% in women, spurring the largest ever single-year drop in overall cancer mortality of 2.2% from 2016 to 2017. Yet lung cancer still caused more deaths in 2017 than breast, prostate, colorectal, and brain cancers combined. Recent mortality declines were also dramatic for melanoma of the skin in the wake of US Food and Drug Administration approval of new therapies for metastatic disease, escalating to 7% annually during 2013 through 2017 from 1% during 2006 through 2010 in men and women aged 50 to 64 years and from 2% to 3% in those aged 20 to 49 years; annual declines of 5% to 6% in individuals aged 65 years and older are particularly striking because rates in this age group were increasing prior to 2013. It is also notable that long-term rapid increases in liver cancer mortality have attenuated in women and stabilized in men. In summary, slowing momentum for some cancers amenable to early detection is juxtaposed with notable gains for other common cancers.
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Affiliation(s)
- Rebecca L Siegel
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Kimberly D Miller
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
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Tao L, Yu H, Dong Y, Tian G, Ren Z, Li D. Metastases with definitive pathological diagnosis but no detectable primary tumor: A surveillance epidemiology and end results-based study. Cancer Med 2019; 8:5872-5880. [PMID: 31407505 PMCID: PMC6792521 DOI: 10.1002/cam4.2496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 12/24/2022] Open
Abstract
Background This study investigates the characteristics of a special type of cancer of unknown primary site (CUP, type 2), which is a metastasis of a definite pathological diagnosis without a detectable primary site. Patients and methods Patients diagnosed between 2004 and 2014 were identified from the Surveillance Epidemiology and End Results (SEER) database. The characteristics of type 2 CUP from different sources were analyzed. For each source of type 2 CUP, tumors of the corresponding TnN0‐XM1 stage were used as controls. Results A total of 8505 patients with type 2 CUP were included in this analysis. Type 2 CUP shows an increasing trend, while type 1 shows the opposite. Type 2 CUPs have significant differences with stage IV of the same pathological primary lesion. Many characteristics influenced the prognosis of type 2 CUP patients, including marital status, age, race, sex, registration time, lymph node metastasis, surgery, chemotherapy, and radiation. Conclusion Our study suggests that identifying the source of metastasis is the key to the selection of treatment and the determination of the prognosis for CUP.
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Affiliation(s)
- Lianyuan Tao
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Haibo Yu
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Yadong Dong
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Guanjing Tian
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Zhiyuan Ren
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
| | - Deyu Li
- Department of Hepatobiliary Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, China
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Gutiérrez-González E, López-Abente G, Aragonés N, Pollán M, Pastor-Barriuso R, Sánchez MJ, Pérez-Gómez B. Trends in mortality from cutaneous malignant melanoma in Spain (1982-2016): sex-specific age-cohort-period effects. J Eur Acad Dermatol Venereol 2019; 33:1522-1528. [PMID: 30868690 DOI: 10.1111/jdv.15565] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/25/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Mortality from malignant cutaneous melanoma increased alarmingly during the second half of the 20th century in Spain and other European countries. OBJECTIVE The aim was to analyse sex- and age-specific trends in melanoma mortality in Spain in the period 1982-2016. METHODS European age-standardized melanoma mortality rates during the period 1982-2016 were calculated from mortality figures provided by the National Statistics Institute. Joinpoint regressions were used to identify significant points of change in trends and to compute average annual per cent change (AAPC). Age-cohort-period models were fitted to explore the effect of these variables on mortality. RESULTS During the period 1982-2016, age-standardized melanoma mortality rates increased in Spain from 0.90 to 1.80 deaths per 100 000 people in men and from 0.64 to 1.11 per 100 000 in women, rising noticeably from 1982 to 1995 in both sexes and in all age groups. From the mid-90s different trends were observed depending on sex and age: there was a decrease in mortality in the population younger than 45 years (AAPC -2 in both sexes) and aged 45-64 years (AAPC -1 among men and -0.2 among women), but in the group over 64 years rates continued to increase (AAPC 1.7 and 0.2, respectively, for men and women). The mortality sex ratio decreased in the younger population but increased in older individuals. A cohort effect was observed with lower mortality in the cohorts born after 1943 in men and 1956 in women. There was also a period effect with decreased mortality rates at the beginning of the 1990s. CONCLUSIONS Melanoma mortality rates in Spain increased during the last decades of the 20th century; however, later they stabilized in women and began to decrease in younger cohorts and middle-aged men. Promotion of primary and secondary prevention measures should continue, with particular emphasis on males over 65 years.
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Affiliation(s)
- E Gutiérrez-González
- Public Health & Preventive Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - G López-Abente
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - N Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - M Pollán
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - R Pastor-Barriuso
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - M J Sánchez
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria (ibs.GRANADA), University of Granada, Granada, Spain
| | - B Pérez-Gómez
- Public Health & Preventive Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
- Cancer & Environmental Epidemiology Unit, National analyze Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Cardiovascular & Metabolic Diseases Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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16
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Rubió-Casadevall J, Puig-Vives M, Puigdemont M, Vilardell L, Carbó-Bagué A, Marcos-Gragera R, Vilar-Coromina N. Patterns of increased incidence and survival of cutaneous melanoma in Girona (Spain) 1994-2013: a population-based study. Clin Transl Oncol 2018; 20:1617-1625. [PMID: 29873027 DOI: 10.1007/s12094-018-1900-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 05/21/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION We conducted a population-based study on the Girona Cancer Registry (Spain) for the period 1994-2013 to determine patterns of change in the incidence of melanoma, which is increasing in many countries, and patient survival in our geographical area. MATERIALS AND METHODS Using the standard registration rules for cancer registries, we calculated crude and standardized incidence rates as well as their trends. We also analysed the observed survival, 1-year conditioned survival and relative survival at 3, 5 and 10 years. RESULTS Our crude incidence rate was 9.13 cases/100,000 inhabitants for invasive and 2.59 for "in situ" melanomas. A statistically significant increase in incidence was found for melanomas of less than 1 mm in Breslow index and in males. 10-year observed and relative survival rates were 64.1 and 83.1%, respectively. CONCLUSIONS We found an increasing trend in the incidence of low-risk melanoma and a survival rate similar to that reported elsewhere in Europe.
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Affiliation(s)
- J Rubió-Casadevall
- Medical Oncology Department, Hospital Josep Trueta, Catalan Institute of Oncology of Girona, Av. França s/n, 17005, Girona, Spain.
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain.
- School of Medicine, University of Girona (UdG), Girona, Spain.
| | - M Puig-Vives
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, Girona, Spain
| | - M Puigdemont
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
- University Hospital Josep Trueta Cancer Registry Coordinator, Catalan Institute of Oncology of Girona, Girona, Spain
- School of Nursery, University of Girona (UdG), Girona, Spain
| | - L Vilardell
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, Girona, Spain
| | - A Carbó-Bagué
- Medical Oncology Department, Hospital Josep Trueta, Catalan Institute of Oncology of Girona, Av. França s/n, 17005, Girona, Spain
| | - R Marcos-Gragera
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
- School of Medicine, University of Girona (UdG), Girona, Spain
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, Girona, Spain
| | - N Vilar-Coromina
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Biomedical Research Institute (IDIBGI), Girona, Spain
- School of Medicine, University of Girona (UdG), Girona, Spain
- Dermatology Department, University Hospital Josep Trueta, Catalan Institute of Health, Girona, Spain
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17
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Lu JW, Miao Y, Guo CX, Ke QF, Yin JH, Zhou SM, Guo YP. Lanthanum-Doped Chitosan Hydrogels Promote the Apoptosis of Melanoma Cells by Bcl-2/Bax Pathway. ACS APPLIED BIO MATERIALS 2018; 1:1468-1477. [DOI: 10.1021/acsabm.8b00417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jia-Wei Lu
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai 200234, China
| | | | - Cui-Xiang Guo
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai 200234, China
| | - Qin-Fei Ke
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai 200234, China
| | | | | | - Ya-Ping Guo
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai 200234, China
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18
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Chirlaque MD, Salmerón D, Galceran J, Ameijide A, Mateos A, Torrella A, Jiménez R, Larrañaga N, Marcos-Gragera R, Ardanaz E, Sant M, Minicozzi P, Navarro C, Sánchez MJ. Cancer survival in adult patients in Spain. Results from nine population-based cancer registries. Clin Transl Oncol 2018; 20:201-211. [PMID: 28718071 DOI: 10.1007/s12094-017-1710-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 06/20/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION With the aim of providing cancer control indicators, this work presents cancer survival in adult (≥15 years) patients in Spain diagnosed during the period 2000-2007 from Spanish cancer registries participating in the EUROCARE project. METHODS Cancer cases from nine Spanish population-based cancer registries were included and analysed as a whole. All primary malignant neoplasms diagnosed in adult patients were eligible for the analysis. Cancer patients were followed until 31 December 2008. For each type of cancer, 1-, 3- and 5-year observed and relative survival were estimated by sex, age and years from diagnosis. Furthermore, age-standardized 5-year relative survival for the period 2000-2007 has been compared with that of the period 1995-1999. RESULTS Skin melanoma (84.6 95% CI 83.0-86.2), prostate (84.6% 95% CI 83.6-85.6) and thyroid (84.2% CI 95% 82.0-86.6) cancers showed the highest 5-year relative survival, whereas the worst prognosis was observed in pancreatic (6% 95% CI 5.1-7.0) and oesophageal (9.4% 95% CI 7.9-11.1) cancers. Overall, survival is higher in women (58.0%) than in men (48.9%). The absolute difference in relative survival between 2000-2007 and 1995-1999 was positive for all cancers as a whole (+4.8% in men, +1.6% in women) and for most types of tumours. Survival increased significantly for chronic myeloid leukaemia, non-Hodgkin's lymphoma and rectum cancer in both sexes, and for acute lymphoid leukaemia, prostate, liver and colon cancers in men and Hodgkin's lymphoma and breast cancer in women. Survival patterns by age were similar in Europe and Spain. A decline in survival by age was observed in all tumours, being more pronounced for ovarian, corpus uteri, prostate and urinary bladder and less for head and neck and rectum cancers. CONCLUSION High variability and differences have been observed in survival among adults in Spain according to the type of cancer diagnosed, from above 84% to below 10%, reflecting high heterogeneity. The differences in prognosis by age, sex and period of diagnosis reveal opportunities for improving cancer care in Spain.
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Affiliation(s)
- M D Chirlaque
- Department of Epidemiology, Regional Health Authority, IMIB-Arrixaca, Murcia University, Ronda de Levante, 11, 30008, Murcia, Spain.
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - D Salmerón
- Department of Epidemiology, Regional Health Authority, IMIB-Arrixaca, Murcia University, Ronda de Levante, 11, 30008, Murcia, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - J Galceran
- Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention, Pere Virgili Health Research Institute, Reus, Spain
| | - A Ameijide
- Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention, Pere Virgili Health Research Institute, Reus, Spain
| | - A Mateos
- Albacete Cancer Registry, Health and Social Welfare Authority, Castile-La Mancha, Spain
| | - A Torrella
- Castellón Cancer Registry, Public Health Directorate, Valencian Government, Castellón, Spain
| | - R Jiménez
- Cuenca Cancer Registry, Health and Social Welfare Authority, Castile-La Mancha, Spain
| | - N Larrañaga
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Basque Country Cancer Registry, Basque Country Regional Authority, Vitoria-Gasteiz, Spain
| | - R Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry (UERCG), Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology (ICO), Girona Biomedical Institute (IDIBGI), University of Girona, Girona, Spain
| | - E Ardanaz
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarre Cancer Registry, Navarre Public Health Institute, Pamplona, Spain
| | - M Sant
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - P Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - C Navarro
- Department of Epidemiology, Regional Health Authority, IMIB-Arrixaca, Murcia University, Ronda de Levante, 11, 30008, Murcia, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M J Sánchez
- CIBER in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Granada Cancer Registry, Andalusian School of Public Health, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
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19
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Abstract
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data were collected by the National Center for Health Statistics. In 2017, 1,688,780 new cancer cases and 600,920 cancer deaths are projected to occur in the United States. For all sites combined, the cancer incidence rate is 20% higher in men than in women, while the cancer death rate is 40% higher. However, sex disparities vary by cancer type. For example, thyroid cancer incidence rates are 3-fold higher in women than in men (21 vs 7 per 100,000 population), despite equivalent death rates (0.5 per 100,000 population), largely reflecting sex differences in the "epidemic of diagnosis." Over the past decade of available data, the overall cancer incidence rate (2004-2013) was stable in women and declined by approximately 2% annually in men, while the cancer death rate (2005-2014) declined by about 1.5% annually in both men and women. From 1991 to 2014, the overall cancer death rate dropped 25%, translating to approximately 2,143,200 fewer cancer deaths than would have been expected if death rates had remained at their peak. Although the cancer death rate was 15% higher in blacks than in whites in 2014, increasing access to care as a result of the Patient Protection and Affordable Care Act may expedite the narrowing racial gap; from 2010 to 2015, the proportion of blacks who were uninsured halved, from 21% to 11%, as it did for Hispanics (31% to 16%). Gains in coverage for traditionally underserved Americans will facilitate the broader application of existing cancer control knowledge across every segment of the population. CA Cancer J Clin 2017;67:7-30. © 2017 American Cancer Society.
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Affiliation(s)
- Rebecca L Siegel
- Strategic Director, Surveillance Information Services, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Kimberly D Miller
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Vice President, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
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Padrik P, Valter A, Valter E, Baburin A, Innos K. Trends in incidence and survival of cutaneous malignant melanoma in Estonia: a population-based study. Acta Oncol 2017; 56:52-58. [PMID: 27796149 DOI: 10.1080/0284186x.2016.1243804] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Previous studies have shown an increase in the incidence of cutaneous melanoma (CM) in Estonia, but also poor survival in international comparisons, with a significant survival gap between the sexes. The aim of this study was to analyze the time trends in CM incidence and relative survival by age, TNM stage and anatomical subsite among men and women in Estonia. MATERIALS AND METHODS Data from the Estonian Cancer Registry were used to calculate age-standardized (World) and age-specific incidence of CM in 1995-2013, and five-year relative survival ratios (RSR) for cases diagnosed in 1995-2012 and followed through in 2014. Period hybrid analysis was used to calculate the most recent survival estimates for 2010-2014. RESULTS Between 1995 and 2013, the age-standardized incidence of CM increased significantly in Estonia among both sexes, at a rate of around 4% per year. Among women, the proportion of trunk melanomas increased from 26% in 1995-1999 to 39% in 2010-2012 and became the most common site. The proportion of stage I cases and T1 tumors increased considerably. Women had more favorable stage distribution and thinner tumors than men. The age-adjusted five-year RSR increased significantly, from 64% in 1995-1999 to 81% in 2010-2014. The latest age-adjusted RSRs were 76% among men and 84% among women. Survival gains were the largest in patients below 50 years, those with head and neck or trunk melanomas, and stage III cancer. CONCLUSIONS The proportion of stage I and T1 cases is lower in Estonia compared with the Scandinavian data and is likely a major contributor to the persisting overall survival deficit in Estonia. The apparent deficit in stage II survival also warrants further investigation. A public health program is necessary in Estonia to raise awareness of CM and to significantly increase early stage diagnosis.
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Affiliation(s)
- Peeter Padrik
- a Tartu University Hospital , Tartu , Estonia
- b University of Tartu , Tartu , Estonia
| | | | | | - Aleksei Baburin
- c Department of Epidemiology and Biostatistics , National Institute for Health Development , Tallinn , Estonia
| | - Kaire Innos
- c Department of Epidemiology and Biostatistics , National Institute for Health Development , Tallinn , Estonia
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