1
|
Rimal R, Robsahm TE, Green AC, Ghiasvand R, Rueegg CS, Bassarova A, Gjersvik P, Weiderpass E, Aalen OO, Møller B, Perrier F, Veierød MB. Trends in Invasive Melanoma Thickness in Norway, 1983-2019. Acta Derm Venereol 2024; 104:adv26110. [PMID: 39221835 DOI: 10.2340/actadv.v104.26110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Monitoring melanoma incidence time trends by tumour thickness is essential to understanding the evolution of melanoma occurrence and guiding prevention strategies. To assess long-term incidence trends, tumour thickness was extracted from pathology reports in the Cancer Registry of Norway (1983-2007) and the Norwegian Melanoma Registry (2008-2019), n = 45,635 patients. Across all anatomic sites, T1 (≤ 1 mm) incidence increased most (men annual percentage change [AAPC] = 4.6, 95% confidence interval [95% CI] 4.2-5.0; women AAPC = 3.2, 95% CI 2.8-3.6); the increase was steep until 1989/90, followed by a plateau, and a further steep increase from 2004/05. Increased incidence was also observed for T2 (>1.0-2.0) melanoma (men AAPC = 2.8, 95% CI 2.4-3.2; women AAPC = 1.5, 95% CI 1.1-1.9), and T3 (>2.0-4.0) in men (AAPC = 1.4, 95% CI 0.9-1.9). T4 (>4.0) melanoma followed a similar overall pattern (men AAPC = 1.3, 95% CI 0.9-1.7, head/neck, upper limbs, and trunk; women AAPC = 0.9, 95% CI 0.4-1.4, upper limbs and trunk). Men had the highest T3 and T4 incidence and the sex difference increased with age. Regarding birth cohorts, age-specific incidence increased in all T categories in the oldest age groups, while stabilizing in younger patients born after 1950. Overall, the steep increase in T1 melanoma was not accompanied by a decrease in thick melanoma.
Collapse
Affiliation(s)
- Raju Rimal
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trude E Robsahm
- Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
| | - Adele C Green
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Cancer Research UK Manchester Institute, University of Manchester, Manchester, United Kingdom
| | - Reza Ghiasvand
- Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway; Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Assia Bassarova
- Department of Pathology, Oslo University Hospital - Ullevål, Oslo, Norway
| | - Petter Gjersvik
- Department of Dermatology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Odd O Aalen
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Oslo, Norway
| | - Bjørn Møller
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Flavie Perrier
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| |
Collapse
|
2
|
Hoyt DW, Thomas SI, Ahmed A, Kristjansson AK, Grant-Kels JM, Ungar JP, Jonasson JG, Adalsteinsson JA. A whole population analysis of sex-specific anatomic differences in melanoma: rising melanoma in situ on the legs and trunk in females. Arch Dermatol Res 2024; 316:384. [PMID: 38864920 DOI: 10.1007/s00403-024-03156-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/08/2024] [Accepted: 05/23/2024] [Indexed: 06/13/2024]
Affiliation(s)
- David W Hoyt
- Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Sierra I Thomas
- Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Areeba Ahmed
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut, Farmington, CT, USA
| | - Jonathan P Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jon Gunnlaugur Jonasson
- Faculty of Medicine, University Hospital of Iceland, Reykjavik, Iceland
- Department of Pathology, Landspitali University Hospital of Iceland, Reykjavik, Iceland
| | - Jonas A Adalsteinsson
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| |
Collapse
|
3
|
Sacchetto L, Rosso S, Comber H, Bouchardy C, Broganelli P, Galceran J, Hackl M, Katalinic A, Louwman M, Robsahm TE, Tryggvadottir L, Tumino R, Van Eycken E, Walsh PM, Zadnik V, Zanetti R. Skin melanoma deaths within 1 or 3 years from diagnosis in Europe. Int J Cancer 2021; 148:2898-2905. [PMID: 33497469 DOI: 10.1002/ijc.33479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/20/2020] [Accepted: 01/04/2021] [Indexed: 01/03/2023]
Abstract
The steep increase in incidence of cutaneous malignant melanoma in white populations mainly applies to thin lesions with good survival suggesting overdiagnosis. Based on population-based cancer registries (CRs), we have investigated changes in aggressive melanoma, selecting only cases who died within 1 or 3 years after diagnosis in 11 European countries between 1995 and 2012. Trends in fatal cases were analysed by period of diagnosis, sex, tumour thickness, histologic subtype of the lesion, tumour site and CR with a multivariate generalised linear mixed effects model, where geographical area was considered as a random effect. We collected data on 123 360 invasive melanomas, with 5133 fatal cases at 1 year (4%) and 12 330 (10%) at 3 years. The number of fatal cases showed a 16% decrease at 1 year and 8% at 3 years between the first (1995-2000) and the last (2007-2012) period. The highest proportion of fatal cases was seen for men, older age (≥65 years), thick lesions (>1 mm), nodular melanoma, melanoma on the trunk and for poorly documented cases, lacking information about thickness and histologic subtype. The mixed-effects model showed a remarkable variability among European countries. The majority of registries showed a decreasing trend in fatal cases, but a few registries showed an opposite pattern. Trends in fatal melanoma cases, highlighting real changes in risk not related to overdiagnosis, showed a decrease in most European countries, with a few exceptions. Stronger efforts for early detection could lead to a more efficient treatment of melanoma in general.
Collapse
Affiliation(s)
- Lidia Sacchetto
- Piedmont Cancer Registry, Turin, Italy
- Department of Mathematical Sciences, Politecnico di Torino, Turin, Italy
- Department of Mathematics, Università degli Studi di Torino, Turin, Italy
| | | | | | | | - Paolo Broganelli
- A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Jaume Galceran
- Servei d'Epidemiologia i Prevenció del Càncer, Hospital Universitari Sant Joan de Reus, ISSPV, Tarragona Cancer Registry, Reus, Spain
| | - Monika Hackl
- Austrian National Cancer Registry, Wien, Austria
| | - Alexander Katalinic
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Marieke Louwman
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Trude E Robsahm
- Department of Research, The Cancer Registry of Norway, Oslo, Norway
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland
- Faculty of Medicine, BMC, Laeknagardur, University of Iceland, Reykjavik, Iceland
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy
| | | | | | - Vesna Zadnik
- Cancer Registry of Republic of Slovenia, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | |
Collapse
|
4
|
Adalsteinsson JA, Olafsdottir E, Ratner D, Waldman R, Feng H, Ungar J, Silverberg JI, Kristjansson AK, Jonasson JG, Tryggvadottir L. Invasive and in situ squamous cell carcinoma of the skin: a nationwide study in Iceland. Br J Dermatol 2021; 185:537-547. [PMID: 33609287 DOI: 10.1111/bjd.19879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND The worldwide incidence of cutaneous squamous cell carcinoma (cSCC) is increasing. OBJECTIVES To evaluate the tumour burden of in situ and invasive cSCC in Iceland, where the population is exposed to limited ultraviolet radiation. METHODS This whole-population study used the Icelandic Cancer Registry, which contains records of all in situ and invasive cSCC cases from 1981 to 2017. Incidence of cSCC was evaluated according to age, anatomical location, residence and multiplicity, and trends were assessed using joinpoint analysis. Age-standardized rates (WSR) and age-specific incidence rates per 100 000 person-years were calculated, along with cumulative and lifetime risks. RESULTS Between 1981 and 2017, in situ cSCC WSR increased from 1·2 to 19·1 for men and from 2·0 to 22·3 for women. Invasive cSCC WSR rose from 4·6 to 14 for men and from 0·3 to 13·2 for women. The average number of in situ cSCC lesions was 1·71 per woman and 1·39 per man. Women developed more in situ cSCCs than invasive cSCCs in almost all anatomical locations, whereas men developed more invasive cSCCs, mostly on the head and neck. The rates of in situ cSCC were higher in Reykjavik compared with rural areas. Furthermore, women more commonly developed multiple in situ lesions. For lip cSCCs, invasive lesions occurred more frequently than in situ lesions among both sexes. Joinpoint analysis showed that in situ cSCC in women exhibited the most rapid incidence increase. CONCLUSIONS cSCC has become an increasingly significant public health problem in Iceland. Tanning bed use and travelling abroad may contribute to skin cancer development. Public health efforts are needed to stem the behaviours leading to this rapid rise in cSCC.
Collapse
Affiliation(s)
- J A Adalsteinsson
- Faculty of Medicine, University of Iceland, Saemundargata 2, Reykjavik, 101, Iceland.,Department of Dermatology, University of Connecticut, 21 South Road, Farmington, CT, USA
| | - E Olafsdottir
- Icelandic Cancer Registry, Skogarhlid 8, Reykjavik, 105, Iceland
| | - D Ratner
- Department of Dermatology, NYU Langone Health, New York, NY, USA
| | - R Waldman
- Department of Dermatology, University of Connecticut, 21 South Road, Farmington, CT, USA
| | - H Feng
- Department of Dermatology, University of Connecticut, 21 South Road, Farmington, CT, USA
| | - J Ungar
- Department of Dermatology, The Mount Sinai Hospital, 1 Gustave L. Levy Place, NY, USA
| | - J I Silverberg
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - A K Kristjansson
- Department of Pathology, Landspitali National-University Hospital, Hringbraut, Reykjavik, 101, Iceland
| | - J G Jonasson
- Faculty of Medicine, University of Iceland, Saemundargata 2, Reykjavik, 101, Iceland.,Department of Pathology, Landspitali National-University Hospital, Hringbraut, Reykjavik, 101, Iceland
| | - L Tryggvadottir
- Faculty of Medicine, University of Iceland, Saemundargata 2, Reykjavik, 101, Iceland.,Icelandic Cancer Registry, Skogarhlid 8, Reykjavik, 105, Iceland
| |
Collapse
|
5
|
Bonachela NL, Kowalski LP, Santos ABDO. Risk factors for positive sentinel lymph nodes in head and neck melanoma - a survival analysis. Braz J Otorhinolaryngol 2020; 87:103-109. [PMID: 33272834 PMCID: PMC9422560 DOI: 10.1016/j.bjorl.2020.09.014] [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: 06/14/2020] [Revised: 08/22/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction Sentinel lymph node biopsy is the gold standard procedure for head and neck cutaneous melanoma staging. Objective To evaluate the technical aspects, positivity and prognostic effect of the cervico-facial sentinel lymph node biopsy. Methods Retrospective, unicentric study. From 2009 to 2014, 49 patients with cutaneous melanoma of the head and neck underwent surgery at Instituto do Câncer do Estado de São Paulo (ICESP). Results Of the 49 patients, 5 had cervical metastasis at the moment of admission. Clark, Breslow and mitotic index were predictors of death. Among the 31 patients undergoing sentinel lymph node biopsy, 3 had positive sentinel lymph nodes (9.7%). Deaths were recorded in two of the cases with positive sentinel lymph nodes (66.6%), and in 5 (17.8%) of the patients with negative lymph nodes. The mean Breslow index was 11.3 mm for primary melanomas with positive sentinel lymph nodes and 4.3 mm for those with negative sentinel lymph nodes. Positivity was associated with Clark and Breslow levels. Malar location showed a protective effect on prognosis. The mean survival for patients with a mitotic index <3.5 was 181 months and 63.4 months for those with a mitotic index >3.5. Conclusion The frequency of positive sentinel lymph node biopsy in patients with malignant melanoma of the head and neck was lower than in other studies, although the sample consisted of individuals with advanced melanomas. The mitotic index was important for prognosis prediction.
Collapse
Affiliation(s)
| | | | - André Bandiera de Oliveira Santos
- Universidade Nove de Julho, Curso de Medicina, São Paulo, SP, Brazil; Instituto do Câncer do Estado de São Paulo, Ambulatório de Tumores Cutâneos na Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| |
Collapse
|
6
|
Bianconi F, Crocetti E, Grisci C, Primieri C, Stracci F. What has changed in the epidemiology of skin melanoma in central Italy during the past 20 years? Melanoma Res 2020; 30:396-401. [PMID: 30480621 DOI: 10.1097/cmr.0000000000000551] [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: 10/27/2022]
Abstract
The aim was to evaluate changes in skin melanoma incidence and mortality at a population level in central Italy over the past two decades. Skin melanoma incidence rate from 1994 to 2014, were retrieved from the Umbrian Cancer Registry (about 900 000 inhabitants). Changes from 1994-1999 to 2010-2014 in tumour and patient characteristics - sex, age (0-44, 45-64, ≥ 65 years), site (head and neck, trunk, limbs), morphology (superficial spreading, nodular, other), thickness (≤ 1, 1-2, 2-4, > 4) and stage I-II, III-IV - were evaluated. Trends in age-standardized incidence and mortality rates were evaluated as annual percent change. During the past two decades, melanoma incidence significantly increased in both sexes (+6%/year among men and +4%/year among women) and in all ages (0-44 years: + 4.7 and + 4.3; 45-64 years: + 6.1 and + 4.4; ≥65 years: + 6.6 and + 1.7), morphologies, except nodular, and stages. Mortality was stable among men and women. In the area, incidence increased for thin and thick melanoma, showing a true increase, whereas mortality did not increase. Therefore, although improvements in treatment and downstaging effect of early diagnosis have to be considered, a certain degree of overdiagnosis cannot be ruled out.
Collapse
Affiliation(s)
| | - Emanuele Crocetti
- Romagna Cancer Registry, IRCCS Istituto scientifico romagnolo per lo studio e la cura dei tumori (IRST), Meldola, Forlì-Cesena
| | - Chiara Grisci
- School of Specialization in Hygiene and Preventive Medicine
| | | | - Fabrizio Stracci
- Umbria Cancer Registry, Umbria
- Department of Experimental Medicine, Public Health Section, University of Perugia, Perugia, Italy
| |
Collapse
|
7
|
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: 99] [Impact Index Per Article: 19.8] [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.
Collapse
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
| |
Collapse
|
8
|
Sacchetto L, Zanetti R, Comber H, Bouchardy C, Brewster DH, Broganelli P, Chirlaque MD, Coza D, Galceran J, Gavin A, Hackl M, Katalinic A, Larønningen S, Louwman MWJ, Morgan E, Robsahm TE, Sanchez MJ, Tryggvadóttir L, Tumino R, Van Eycken E, Vernon S, Zadnik V, Rosso S. Trends in incidence of thick, thin and in situ melanoma in Europe. Eur J Cancer 2018; 92:108-118. [PMID: 29395684 DOI: 10.1016/j.ejca.2017.12.024] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/14/2017] [Accepted: 12/21/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND We analysed trends in incidence for in situ and invasive melanoma in some European countries during the period 1995-2012, stratifying for lesion thickness. MATERIAL AND METHODS Individual anonymised data from population-based European cancer registries (CRs) were collected and combined in a common database, including information on age, sex, year of diagnosis, histological type, tumour location, behaviour (invasive, in situ) and lesion thickness. Mortality data were retrieved from the publicly available World Health Organization database. RESULTS Our database covered a population of over 117 million inhabitants and included about 415,000 skin lesions, recorded by 18 European CRs (7 of them with national coverage). During the 1995-2012 period, we observed a statistically significant increase in incidence for both invasive (average annual percent change (AAPC) 4.0% men; 3.0% women) and in situ (AAPC 7.7% men; 6.2% women) cases. DISCUSSION The increase in invasive lesions seemed mainly driven by thin melanomas (AAPC 10% men; 8.3% women). The incidence of thick melanomas also increased, although more slowly in recent years. Correction for lesions of unknown thickness enhanced the differences between thin and thick cases and flattened the trends. Incidence trends varied considerably across registries, but only Netherlands presented a marked increase above the boundaries of a funnel plot that weighted estimates by their precision. Mortality from invasive melanoma has continued to increase in Norway, Iceland (but only for elder people), the Netherlands and Slovenia.
Collapse
Affiliation(s)
- L Sacchetto
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy; Politecnico di Torino, Turin, Italy; Università degli Studi di Torino, Turin, Italy.
| | - R Zanetti
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
| | - H Comber
- National Cancer Registry Ireland, Ireland
| | | | | | - P Broganelli
- A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
| | - M D Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, CIBERESP, Spain
| | - D Coza
- Cluj Regional Cancer Registry, Oncology Institute Cluj, Romania
| | - J Galceran
- Tarragona Cancer Registry, Foundation Society for Cancer Research and Prevention, (FUNCA), Pere Virgili Health Research Institute (IISPV), Reus, Spain
| | - A Gavin
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - M Hackl
- Austrian National Cancer Registry, Wien, Austria
| | - A Katalinic
- Institute for Social Medicine and Epidemiology, University Lübeck, Lubeck, Germany
| | - S Larønningen
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - M W J Louwman
- Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - E Morgan
- Northern Ireland Cancer Registry, Queens University Belfast, Belfast, UK
| | - T E Robsahm
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - M J Sanchez
- Escuela Andaluza de Salud Pública, CIBER de Epidemiología y Salud Pública, (CIBERESP), Ibs, Granada, Spain
| | - L Tryggvadóttir
- Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland
| | - R Tumino
- Cancer Registry and Histopathology Department, "Civic - M.P.Arezzo" Hospital, ASP, Ragusa, Italy
| | | | - S Vernon
- National Cancer Registration Service - Public Health England, Cambridge, UK
| | - V Zadnik
- Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - S Rosso
- Piedmont Cancer Registry, A.O.U, Città della Salute e della Scienza di Torino, Turin, Italy
| |
Collapse
|
9
|
Environmental effects of ozone depletion and its interactions with climate change: Progress report, 2016. Photochem Photobiol Sci 2017; 16:107-145. [PMID: 28124708 PMCID: PMC6400464 DOI: 10.1039/c7pp90001e] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/05/2017] [Indexed: 12/12/2022]
Abstract
The Parties to the Montreal Protocol are informed by three Panels of experts. One of these is the Environmental Effects Assessment Panel (EEAP), which deals with two focal issues. The first focus is the effects of UV radiation on human health, animals, plants, biogeochemistry, air quality, and materials. The second focus is on interactions between UV radiation and global climate change and how these may affect humans and the environment. When considering the effects of climate change, it has become clear that processes resulting in changes in stratospheric ozone are more complex than previously believed. As a result of this, human health and environmental issues will be longer-lasting and more regionally variable. Like the other Panels, the EEAP produces a detailed report 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 Progress Reports of the relevant scientific findings. The most recent of these was for 2015 (Photochem. Photobiol. Sci., 2016, 15, 141-147). The present Progress Report for 2016 assesses some of the highlights and new insights with regard to the interactive nature of the direct and indirect effects of UV radiation, atmospheric processes, and climate change. The more detailed Quadrennial Assessment will be made available in 2018.
Collapse
|
10
|
Crocetti E, Mallone S, Robsahm TE, Gavin A, Agius D, Ardanaz E, Lopez MDC, Innos K, Minicozzi P, Borgognoni L, Pierannunzio D, Eisemann N. Survival of patients with skin melanoma in Europe increases further: Results of the EUROCARE-5 study. Eur J Cancer 2015; 51:2179-2190. [PMID: 26421821 DOI: 10.1016/j.ejca.2015.07.039] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/08/2015] [Accepted: 07/20/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND In Europe skin melanoma (SM) survival has increased over time. The aims were to evaluate recent trends and differences between countries and regions of Europe. METHODS Relative survival (RS) estimates and geographical comparisons were based on 241,485 patients aged 15years and over with a diagnosis of invasive SM in Europe (2000-2007). Survival time trends during 1999-2007 were estimated using the period approach, for 213,101 patients. Age, gender, sub-sites and morphology subgroups were considered. RESULTS In European patients, estimated 5-year RS was 83% (95% confidence interval, CI 83-84%). The highest values were found for patients resident in Northern (88%; 87-88%) and Central (88%; 87-88%) Europe, followed by Ireland and United Kingdom (UK) (86%; 85-86%) and Southern Europe (83%; 82-83%). The lowest survival was in Eastern Europe (74%; 74-75%). Within regions the intercountry absolute difference in percentage points of RS varied from 4% (North) to 34% (East). RS decreased markedly with patients' age and was higher in women than men. Differences according to SM morphology and skin sub-sites also emerged. Survival has slightly increased from 1999 to 2007, with a small improvement in Northern and the most pronounced improvement in Eastern Europe. DISCUSSION SM survival is high and still increasing in European patients. The gap between Northern and Southern and especially Eastern European countries, although still present, diminished over time. Differences in stage distribution at diagnosis may explain most of the geographical differences. However, part of the improvement in survival may be attributed to overdiagnosis from early diagnosis practices.
Collapse
Affiliation(s)
- Emanuele Crocetti
- UO Epidemiologia Clinica, Descrittiva e Registri - ISPO, Firenze, Italy.
| | - Sandra Mallone
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Trude Eid Robsahm
- Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queens University, Belfast, Northern Ireland, UK
| | - Domenic Agius
- Malta National Cancer Registry, Department of Health Information and Research, Pieta, Malta
| | - Eva Ardanaz
- Navarra Cancer Registry, Navarra Public Health Institute, Pamplona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Maria-Dolores Chirlaque Lopez
- Servicio de Epidemiología, Department of Epidemiology, Consejería de Sanidad, Murcia Health Authority, Murcia, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Kaire Innos
- Department of Epidemiology and Biostatistics National, Institute for Health Development, Tallinn, Estonia
| | - Pamela Minicozzi
- Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lorenzo Borgognoni
- SC Chirurgia Plastica e Ricostruttiva, Ospedale S.M. Annunziata - Azienda Sanitaria di Firenze Centro di Riferimento Regionale per il Melanoma, Istituto Toscano Tumori, Firenze, Italy
| | - Daniela Pierannunzio
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Nora Eisemann
- Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany
| | | |
Collapse
|