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Álvarez-Buylla-Puente MC, Adsuar Mas J, Terrasa Sagristá F, Nadal Nadal A, Nadal Lladó C, Llambrich Mañés A. Epidemiology of Primary Cutaneous Melanoma in the Migjorn Health Sector of Mallorca, Spain From 2003 Through 2021. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00257-6. [PMID: 38554754 DOI: 10.1016/j.ad.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/27/2023] [Accepted: 07/03/2023] [Indexed: 04/02/2024] Open
Abstract
The study of the increasing incidence of melanoma over the past few decades is essential regarding prevention and optimization of health resources. We collected cases of melanoma from Hospital son Llàtzer from the Migjorn health sector of Mallorca, Spain from 2003 through 2021, and calculated the incidence of melanoma adjusted to the standard European population. In addition, other demographic and clinicopathological data were descriptively analyzed too. A total of 690 new cases of melanoma were detected with a progressive increase in the age-standardized incidence from 7.47 cases per 100,000 inhabitants/year in 2003 up to 23.84 in 2021 mainly due to early stages of the disease. The incidence of melanoma has increased significantly in Mallorca probably due to the increasing population coming from northern Europe (low phototypes), sun exposure habits (tourism, fishing, agriculture), and improved early diagnosis.
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Affiliation(s)
| | - J Adsuar Mas
- Servicio de Dermatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - F Terrasa Sagristá
- Servicio de Anatomía Patológica, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - A Nadal Nadal
- Servicio de Dermatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - C Nadal Lladó
- Servicio de Dermatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
| | - A Llambrich Mañés
- Servicio de Dermatología, Hospital Universitario Son Llàtzer, Palma de Mallorca, España
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2
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Bucchi L, Mancini S, Crocetti E, Dal Maso L, Baldacchini F, Vattiato R, Giuliani O, Ravaioli A, Zamagni F, Bella F, Bidoli E, Caldarella A, Candela G, Carone S, Carrozzi G, Cavallo R, Ferrante M, Ferretti S, Filiberti RA, Fusco M, Gatti L, Gili A, Iacovacci S, Magoni M, Mangone L, Mazzoleni G, Michiara M, Musolino A, Piffer S, Piras D, Rizzello RV, Rosso S, Rugge M, Scala U, Stracci F, Tagliabue G, Toffolutti F, Tumino R, Biggeri A, Masini C, Ridolfi L, Villani S, Palmieri G, Stanganelli I, Falcini F. The descriptive epidemiology of melanoma in Italy has changed - for the better. Ital J Dermatol Venerol 2023; 158:483-492. [PMID: 38015485 DOI: 10.23736/s2784-8671.23.07653-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
A recent research project using data from a total of 40 cancer registries has provided new epidemiologic insights into the results of efforts for melanoma control in Italy between the 1990s and the last decade. In this article, the authors present a summary and a commentary of their findings. Incidence increased significantly throughout the study period in both sexes. However, the rates showed a stabilization or a decrease in men and women aged below 35 years. The risk of disease increased for successive cohorts born until 1973 (women) and 1975 (men) while subsequently tending to decline. The trend towards decreasing tumor thickness and increasing survival has continued, but a novel favorable prognostic factor has emerged since 2013 for patients - particularly for males - with thick melanoma, most likely represented by molecular targeted therapies and immune checkpoint inhibitors. Due to this, the survival gap between males and females has been filled out. In the meanwhile, and despite the incidence increase, dermatologists have not lowered their threshold to perform skin biopsy. Skin biopsy rate has increased because of the increasingly greater volume of dermatologic office visits, but the proportion of skin biopsies out of dermatologic office visits has remained constant. In summary, an important breakthrough in melanoma control in Italy has taken place. Effective interventions have been implemented across the full scope of care, which involve many large local populations - virtually the whole national population. The strategies adopted during the last three decades represent a valuable basis for further steps ahead in melanoma control in Italy.
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Affiliation(s)
- Lauro Bucchi
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Silvia Mancini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy -
| | - Emanuele Crocetti
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Federica Zamagni
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Francesca Bella
- Siracusa Cancer Registry, Azienda Sanitaria Provinciale (ASP), Siracusa, Italy
| | - Ettore Bidoli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Giuseppa Candela
- Trapani Cancer Registry, Department of Prevention, Servizio Sanitario Regionale Sicilia, Azienda Sanitaria Provinciale (ASP), Trapani, Italy
| | - Simona Carone
- Taranto Cancer Registry, Unit of Statistics and Epidemiology, ASL Taranto, Taranto, Italy
| | | | | | - Margherita Ferrante
- Integrated Cancer Registry of Catania-Messina-Enna, Rodolico-San Marco Polyclinic University Hospital, Catania, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry - Section of Ferrara, ASL Ferrara, University of Ferrara, Ferrara, Italy
| | - Rosa A Filiberti
- Liguria Cancer Registry, San Martino Polyclinic Hospital IRCCS, Genoa, Italy
| | | | - Luciana Gatti
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantua, Italy
| | - Alessio Gili
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | | | - Michele Magoni
- Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, Brescia, Italy
| | - Lucia Mangone
- Epidemiology Unit, AUSL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, Parma University Hospital, Parma, Italy
| | - Antonino Musolino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Medical Oncology Unit and Cancer Registry, Parma University Hospital, Parma, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Daniela Piras
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute (ATS), Sassari, Italy
| | - Roberto V Rizzello
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Fabrizio Stracci
- Umbria Cancer Registry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giovanna Tagliabue
- Lombardy Cancer Registry of Varese Province, Cancer Registry Unit, Department of Research, National Cancer Institute IRCCS Foundation, Milan, Italy
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Rosario Tumino
- Cancer Registry, Department of Histopathology, Provincial Health Authority (ASP), Ragusa, Italy
| | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Carla Masini
- Unit of Oncological Pharmacy, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Laura Ridolfi
- Department of Immunotherapy, Cell Therapy and Biobank, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
| | - Simona Villani
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - Giuseppe Palmieri
- Department of Immuno-oncology and Targeted Oncologic Biotherapies, University of Sassari, Sassari, Italy
- Unit of Tumor Genetics, IRGB-CNR, Sassari, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Forlì-Cesena, Italy
- Cancer Prevention Unit, ASL Forlì, Forlì-Cesena, Italy
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Segura S, Podlipnik S, Boada A, Martí RM, Sabat M, Yélamos O, Zarzoso-Muñoz I, Azón-Masoliver A, López-Castillo D, Solà J, Baliu-Piqué C, Galvany-Rossell L, Pasquali P, Just-Sarobé M, Duran X, Carrera C, Richarz NA, Pujol RM, Malvehy J, Puig S. Melanoma-specific survival is worse in the elderly: a multicentric cohort study. Melanoma Res 2023; 33:532-538. [PMID: 37696262 DOI: 10.1097/cmr.0000000000000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
We aimed to characterise cutaneous melanoma in the elderly and determine its association with poorer prognosis. We studied a prospective cohort of the melanoma population in Catalonia between 2012 and 2016. We compared young patient group (<75 years old) with elderly patient group (≥75 years old). We included 3009 patients (52.5% women) from 14 centres, with a mean age at diagnosis of 61.1 years. In the ≥75-year-old group there was a predominance of men (53.9% vs. 45.5%, P < 0.001), melanoma was more frequently located in the head and neck area (37.7% vs. 15.5%, P < 0.001) and lentigo maligna melanoma subtype was significantly more frequent (31.4% vs. 11.6%, P < 0.001), as were nodular melanoma and acral lentiginous melanoma ( P < 0.001). In older people, Breslow index, the presence of ulceration and mitotic rate were higher than in younger people. Kaplan-Meier survival curves showed longer melanoma-specific survival (MSS) and melanoma-free survival (MFS) in <75-year-old group compared to the elderly group. Cox regression models demonstrated reduced MSS in patients ≥75 years regardless of gender, location, IB, ulceration and lymph node status at diagnosis (HR 1.54, P = 0.013) whereas MFS was not independently associated with elderly when head and neck location was considered. Age appears to be an independent risk factor for MSS but not for MFS. Worse melanoma prognosis in elderly could be explained by factors unrelated to the tumour, such as age-related frailty and comorbidities that limit the access to systemic treatments and, eventually, age-related immune dysfunction.
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Affiliation(s)
- Sonia Segura
- Dermatology Department, Hospital del Mar and Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, Barcelona
- Universitat de Vic-Universitat Central de Catalunya (UVIC), Vic
| | - Sebastian Podlipnik
- Dermatology Department, University of Barcelona, Hospital Clínic de Barcelona, IDIBAPS, Barcelona and CIBERER, Instituto de Salud Carlos III
| | - Aram Boada
- Dermatology Department, Hospital Germans Trias i Pujol de Badalona, Badalona
| | - Rosa M Martí
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida and Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III
| | - Mireia Sabat
- Dermatology Department, Hospital Universitari Parc Taulí, Sabadell
| | - Oriol Yélamos
- Dermatology Department, Hospital de Santa Creu i Sant Pau de Barcelona, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona
| | | | | | - Daniel López-Castillo
- Dermatology Department Consorci Sanitari Integral Hospital Moises Broggi, Sant Joan Despí
| | - Joaquim Solà
- Dermatology Department, Hospital General de Granollers, Granollers
| | | | | | - Paola Pasquali
- Dermatology Department, Pius Hospital de Valls, Valls and Universidad de Alcalá, Alcalá de Henares
| | | | - Xavier Duran
- Methodology and Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona
| | - Cristina Carrera
- Dermatology Department, University of Barcelona, Hospital Clínic de Barcelona, IDIBAPS, Barcelona and CIBERER, Instituto de Salud Carlos III
| | - Nina A Richarz
- Dermatology Department, Hospital Germans Trias i Pujol de Badalona, Badalona
| | - Ramon M Pujol
- Dermatology Department, Hospital del Mar and Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Universitat Pompeu Fabra, Barcelona
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep Malvehy
- Dermatology Department, University of Barcelona, Hospital Clínic de Barcelona, IDIBAPS, Barcelona and CIBERER, Instituto de Salud Carlos III
| | - Susana Puig
- Dermatology Department, University of Barcelona, Hospital Clínic de Barcelona, IDIBAPS, Barcelona and CIBERER, Instituto de Salud Carlos III
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Regional variability of melanoma incidence and prevalence in Hungary. Epidemiological impact of ambient UV radiation and socioeconomic factors. Eur J Cancer Prev 2021; 31:377-384. [PMID: 34545023 DOI: 10.1097/cej.0000000000000716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The incidence of cutaneous melanoma has risen faster than almost any other type of cancer in the last 50 years. Ultraviolet (UV) radiation and genetic susceptibility are the most important risk factors. OBJECTIVE We aimed to determine the epidemiologic indicators of melanoma in Hungary, a country with an estimated population of 9.8 million and an area of 93 030 km2. METHODS Anonymized patient records from the National Health Insurance Fund Management covering the entire population were used to determine the incidence and prevalence of melanoma in the counties of Hungary from 2013 to 2017. Altogether 20 030 melanoma cases were identified for inclusion in this study. RESULTS The prevalence of melanoma increased over the investigated period and was significantly higher among women than men. The incidence of melanoma stagnated during this period and the incidence rate was the highest among the elderly. Interestingly, the incidence was higher in males in the elderly population, while the incidence was higher in females in the younger (<60 years) population. Geographical variations in ambient UV radiation did not show statistically significant correlation with the regional variability of epidemiologic indicators, probably due to small differences in the number of bright sunshine hours per year between regions. Although Hungary is a relatively small country, we observed regional heterogeneity in socioeconomic factors. Notably, a significant and strong negative correlation was found between single-person household rates and melanoma prevalence. CONCLUSION In addition to ambient UV radiation, melanoma incidence and prevalence appear to be related to age, gender and socioeconomic factors.
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Incidence of Melanoma in Catalonia, Spain, Is Rapidly Increasing in the Elderly Population. A Multicentric Cohort Study. J Clin Med 2020; 9:jcm9113396. [PMID: 33113930 PMCID: PMC7690683 DOI: 10.3390/jcm9113396] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 12/24/2022] Open
Abstract
The incidence of melanoma has been increasing worldwide during recent decades. The objective of the study was to analyse the trends in incidence for in situ and invasive melanoma in the Spanish region of Catalonia during the period of 2008-2017. We designed a cross-sectional study with an age-period-cohort analysis of melanoma patient data from the Network of Melanoma Centres in Catalonia. Our database covered a population of over seven million and included a total of 8626 patients with incident melanoma. The main outcome measures were crude and age-standardised incidence rates to the European 2013 standard population. Joinpoint regression models were used to evaluate the population trends. We observed an increase in the age-standardised incidence rate (per 100,000 population) of all melanoma subtypes from 11.56 in 2008 to 13.78 in 2017 with an average annual percent change (AAPC) of 3.5%. This incidence increase was seen exclusively in the older population. Moreover, the stratified analysis showed a statistically significant increase in the age-standardised incidence rate for invasive (AAPC 2.1%) and in situ melanoma (AAPC 6.5%). In conclusion, the incidence of melanoma has continued to increase in the elderly population over recent decades, with a rapidly increasing trend of in situ melanomas and the lentigo maligna subtype.
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Bucchi L, Mancini S, Crocetti E, Dal Maso L, Baldacchini F, Vattiato R, Giuliani O, Ravaioli A, Caldarella A, Carrozzi G, Ferretti S, Filiberti RA, Fusco M, Gatti L, Gili A, Magoni M, Mangone L, Mazzoleni G, Michiara M, Panato C, Piffer S, Piras D, Rosso S, Rugge M, Scala U, Tagliabue G, Tumino R, Stanganelli I, Falcini F. Mid-term trends and recent birth-cohort-dependent changes in incidence rates of cutaneous malignant melanoma in Italy. Int J Cancer 2020; 148:835-844. [PMID: 33405292 DOI: 10.1002/ijc.33259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 01/12/2023]
Abstract
In Oceania, North America and north-western Europe, after decades of increase, cutaneous malignant melanoma (CMM) rates began to stabilise or decline before 2000. Anecdotal evidence suggests that the reversal of the incidence trend is extending to southern Europe. To obtain a formal confirmation, this nationwide study from Italy investigated the incidence trends by birth cohort. Twenty-one local cancer registries covering a population of 15 814 455 provided incidence data for primary CMM registered between 1994 and 2013. Trends in age-standardised rates were analysed using joinpoint regression models and age-period-cohort models. Age-standardised incidence showed a consistent increase throughout the period (estimated annual percent change, 3.6 [95% confidence interval, 3.2-4.0] among men and 2.5 [2.0-3.1] among women). This pattern was confirmed by a sensitivity analysis with removal of low-risk populations of southern Italy. The rates, however, showed a stabilisation or a decrease in men and women aged below 35. Using the cohort of 1949-the median cohort with respect to the number of cases for both genders-as a reference, the incidence rate ratio increased for successive cohorts born until 1973 (women) and 1975 (men), and subsequently tended to decline. For the most recent cohorts in both genders, the risk of disease returned to the level of the cohort of 1949. The changes observed in the latest generations can be interpreted as the earliest manifestations of a birth-cohort-dependent incidence decrease. Our study adds to previous data indicating that the reversal of the long-term upward incidence trend of CMM is extending to southern Europe.
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Affiliation(s)
- Lauro Bucchi
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Silvia Mancini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Emanuele Crocetti
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Flavia Baldacchini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Rosa Vattiato
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Orietta Giuliani
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health Department, Local Health Authority, Modena, Italy
| | - Stefano Ferretti
- Romagna Cancer Registry, section of Ferrara, Local Health Authority, and University of Ferrara, Ferrara, Italy
| | | | | | - Luciana Gatti
- Mantova Cancer Registry, Epidemiology Unit, Agenzia di Tutela della Salute (ATS) della Val Padana, Mantova, Italy
| | - Alessio Gili
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Michele Magoni
- Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, Brescia, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Chiara Panato
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Silvano Piffer
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Trento, Italy
| | - Daniela Piras
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute - ATS, Sassari, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), Ragusa, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.,Department of Dermatology, University of Parma, Parma, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì, Italy.,Cancer Prevention Unit, Local Health Authority, Forlì, Italy
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Increasing melanoma incidence in the elderly in North-East Hungary: is this a more serious problem than we thought? Eur J Cancer Prev 2020; 28:544-550. [PMID: 30399042 DOI: 10.1097/cej.0000000000000489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
There is a great need for efficient and cost-effective melanoma screening, but this is not yet solved. Epidemiological studies on trends in melanoma incidence by tumour thickness, anatomical site and demographical data can help to improve public health efforts regarding earlier melanoma diagnosis. We aimed to study the trends in the incidence and characteristics of patients and their melanoma in North-East Hungary from 2000 to 2014. Data were obtained from a university hospital-based registry. A total of 1509 cutaneous invasive melanomas of 1464 patients were included in the study. A moderate but significant increase in incidence was observed in the region [average annual percentage change: 3.04 (0.07; 6.11); P = 0.045], with a breakpoint in 2007. From 2001 to 2007, the trend was increasing [APC: 9.84 (3.52; 16.55); P=0.006], but it stalled from 2007 [APC: -2.45 (-5.99; 1.23); P = 0.164]. However, in the age groups over the age of 60 years, where the standardised incidence was the highest, the incidence continued to rise. Furthermore, older age, male sex and trunk or lower extremity localization were found to be associated with thicker melanomas. Our results support that regular screening examination for melanoma would be desirable for people over the age of 60 years.
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Mir JF, Estrada-Campmany M, Heredia A, Rodríguez-Caba C, Alcalde M, Espinosa N, Monnier J, Pérez-Anker J, Yélamos O, Puig S, Bosch N, Malvehy J. Role of community pharmacists in skin cancer screening: A descriptive study of skin cancer risk factors prevalence and photoprotection habits in Barcelona, Catalonia, Spain. Pharm Pract (Granada) 2019; 17:1455. [PMID: 31592287 PMCID: PMC6763307 DOI: 10.18549/pharmpract.2019.3.1455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/28/2019] [Indexed: 01/05/2023] Open
Abstract
Background: Skin cancer incidence is increasing alarmingly, despite current efforts
trying to improve its early detection. Community pharmacists have proven
success in implementing screening protocols for a number of diseases because
of their skills and easy access. Objective: To evaluate the prevalence of skin cancer risk factors and the
photoprotection habits with a questionnaire in community pharmacy users. Methods: A research group consisting of pharmacists and dermatologists conducted a
descriptive cross-sectional study to assess photoprotection habits and skin
cancer risk factors by using a validated questionnaire in 218 community
pharmacies in Barcelona from May 23rd to June 13th
2016. All participants received health education on photoprotection and skin
cancer prevention. Patients with ≥1 skin cancer risk factor were
referred to their physician, as they needed further screening of skin
cancer. Results: A total of 5,530 participants were evaluated. Of those, only 20.2%
participants had received a total body skin examination for skin cancer
screening in the past by a physician and 57.1% reported using a SPF
50+ sunscreen. 53.9% participants presented ≥1 skin cancer
risk factor: 11.8% participants reported having skin cancer familial
history and 6.2% reported skin cancer personal history; pharmacists
found ≥10 melanocytic nevi in 43.8% participants and
chronically sun-damaged skin in 21.4%. Lesions suspicious for
melanoma were reported in 10.9% of the participants and urgent
dermatological evaluation was recommended. Conclusions: Pharmacists can detect people with skin cancer risk factors amongst their
users. This intervention can be considered in multidisciplinary strategies
of skin cancer screening.
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Affiliation(s)
- Joan F Mir
- Consultant Pharmacist in Research and Projects Area. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Maria Estrada-Campmany
- Consultant Pharmacist in Research and Projects Area. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Anna Heredia
- Professional Relations Manager. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Cristina Rodríguez-Caba
- Head of Department of Continuous Professional Development. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Marta Alcalde
- Community Pharmacist. Dermopharmacy and Medical Devices Area. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Natalia Espinosa
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona (Spain).
| | - Jilliana Monnier
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona (Spain).
| | - Javiera Pérez-Anker
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona (Spain).
| | - Oriol Yélamos
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona (Spain).
| | - Susana Puig
- Dermatologist. Melanoma Unit, Dermatology Department, IDIBAPS-Hospital Clinic. Barcelona; & Biomedical Research Networking Centers Consortium, Institute of Health Carlos III (CIBER-ISCIII). Barcelona (Spain).
| | - Núria Bosch
- Community Pharmacist. Dermopharmacy and Medical Devices Area. Barcelona Pharmacists Association (COFB). Barcelona (Spain).
| | - Josep Malvehy
- Dermatologist. Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).Centro de Investigación Biomédica en Red (CIBER), Instituto Carlos III, Barcelona (Spain).
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9
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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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10
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Pandiaraja J. Cutaneous Malignant Melanoma and Targeted Therapy Based on the Biomarkers. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_204_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractMalignant melanoma is the most aggressive form of cutaneous malignancy. It accounts for more than 75% of cancer-related deaths among cutaneous malignancies. It accounts for <5% of cutaneous malignancy. Numerous biomarkers are used in malignant melanoma with varying clinical applications, including diagnostic purposes, prognosis, therapeutic purpose, and targeted therapy against melanoma. Systemic chemotherapy in malignant melanoma has little benefit compared to immunotherapy and targeted therapy. The observed overall survival with systemic chemotherapy is much less compared with targeted therapy in advanced or metastatic melanoma. Various targeted therapies are currently used in melanoma treatment including BRAF inhibitors such as vemurafenib and dabrafenib; MEK inhibitors such as trametinib; anti-CTLA-4 antibodies such as ipilimumab; and anti-programmed cell death 1 antibodies such as nivolumab, pembrolizumab, and pidilizumab. This study discusses the role of biomarkers and targeted therapies based on the biomarker.
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Affiliation(s)
- Jayabal Pandiaraja
- Department of General Surgery, Care Hospital, Chennai, Tamil Nadu, India
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11
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Podlipnik S, Carrera C, Boada A, Richarz NA, López-Estebaranz JL, Pinedo-Moraleda F, Elosua-González M, Martín-González MM, Carrillo-Gijón R, Redondo P, Moreno E, Malvehy J, Puig S. Early outcome of a 31-gene expression profile test in 86 AJCC stage IB-II melanoma patients. A prospective multicentre cohort study. J Eur Acad Dermatol Venereol 2019; 33:857-862. [PMID: 30702163 PMCID: PMC6483866 DOI: 10.1111/jdv.15454] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 01/04/2019] [Indexed: 12/23/2022]
Abstract
Background The clinical and pathological features of primary melanoma are not sufficiently sensitive to accurately predict which patients are at a greater risk of relapse. Recently, a 31‐gene expression profile (DecisionDx‐Melanoma) test has shown promising results. Objectives To evaluate the early prognostic performance of a genetic signature in a multicentre prospectively evaluated cohort. Methods Inclusion of patients with AJCC stages IB and II conducted between April 2015 and December 2016. All patients were followed up prospectively to assess their risk of relapse. Prognostic performance of this test was evaluated individually and later combined with the AJCC staging system. Prognostic accuracy of disease‐free survival was determined using Kaplan–Meier curves and Cox regression analysis. Results of the gene expression profile test were designated as Class 1 (low risk) and Class 2 (high risk). Results Median follow‐up time was 26 months (IQR 22–30). The gene expression profile test was performed with 86 patients; seven had developed metastasis (8.1%) and all of them were in the Class 2 group, representing 21.2% of this group. Gene expression profile was an independent prognostic factor for relapse as indicated by multivariate Cox regression analysis, adjusted for AJCC stages and age. Conclusions This prospective multicentre cohort study, performed in a Spanish Caucasian cohort, shows that this 31‐gene expression profile test could correctly identify patients at early AJCC stages who are at greater risk of relapse. We believe that gene expression profile in combination with the AJCC staging system could well improve the detection of patients who need intensive surveillance and optimize follow‐up strategies.
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Affiliation(s)
- S Podlipnik
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - C Carrera
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Boada
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - N A Richarz
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J L López-Estebaranz
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - F Pinedo-Moraleda
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M Elosua-González
- Department of Dermatology, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M M Martín-González
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - R Carrillo-Gijón
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - P Redondo
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - E Moreno
- Department of Dermatology, University Clinic of Navarra, Pamplona, Spain
| | - J Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - S Puig
- Department of Dermatology, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
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12
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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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13
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Matas-Nadal C, Malvehy J, Ferreres JR, Boada A, Bodet D, Segura S, Salleras M, Azon A, Bel-Pla S, Bigata X, Campoy A, Curcó N, Dalmau J, Formigon M, Gonzalez A, Just M, Llistosella E, Nogues ME, Pedragosa R, Pujol JA, Sabat M, Smandia JA, Zaballos P, Puig S, Martí RM. Increasing incidence of lentigo maligna and lentigo maligna melanoma in Catalonia. Int J Dermatol 2018; 58:577-581. [PMID: 30548854 DOI: 10.1111/ijd.14334] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/30/2018] [Accepted: 11/14/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recent epidemiological studies suggest that past data where superficial spreading melanoma was by far the most common subtype of melanoma may not reflect current patterns of sun exposure or other risk factors more involved in other subtypes of melanoma as lentigo maligna (LM) or lentigo maligna melanoma (LMM). METHODS In order to measure the current situation in our country, all cases of LM and LMM diagnosed in 23 hospitals in Catalonia, from 2000 to 2007, were recorded. RESULTS Although for the global period LM/LMM represented only 8.4% of cases, an increasing trend in this percentage was observed throughout the study period (from 6.9% [27 cases] in 2000 to 13.1% [94 cases] in 2007). Also, an increasing incidence of LM/LMM was observed, especially in chronically sun-exposed areas (85.5% involving the head and neck region). During the 8 years of the registry, the mean Breslow thickness of LMM remained stable. However, the increase in the number of LM (in situ) cases was significantly higher than the increase of the invasive ones. CONCLUSIONS An important observation from this data is that aging of population and current sun exposure patterns could keep increasing the incidence of LM/LMM, which may become an important public healthcare problem, over the other histological subtypes. In order to establish primary or secondary preventive measures to the LM/LMM risk-population, it is imperative to highlight the importance of chronic sun damage as a melanoma risk factor, and not only sunburn, most commonly addressed in melanoma prevention campaigns.
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Affiliation(s)
- Clara Matas-Nadal
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida & CIBERONC, Lleida, Spain
| | - Josep Malvehy
- Department of Dermatology, Hospital Clínic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain
| | - Jose Ramon Ferreres
- Department of Dermatology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Aram Boada
- Department of Dermatology, Universitari Germans Trias i Pujol, Badalona, Spain
| | - Domingo Bodet
- Department of Dermatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Sonia Segura
- Department of Dermatology, Hospital del Mar, IMIM, Barcelona, Spain
| | - Montse Salleras
- Department of Dermatology, Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - Antoni Azon
- Department of Dermatology, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Susana Bel-Pla
- Department of Dermatology, Hospital Comarcal d'Amposta, Amposta, Spain
| | - Xavier Bigata
- Department of Dermatology, Hospital de Mataró, Mataró, Spain
| | - Antoni Campoy
- Department of Dermatology, Hospital General de Catalunya, Sant Cugat, Spain
| | - Neus Curcó
- Department of Dermatology, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - Joan Dalmau
- Department of Dermatology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Manel Formigon
- Department of Dermatology, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Alberto Gonzalez
- Department of Dermatology, Consorci Sanitari Integral, L'Hospitalet de Llobregat, Spain
| | - Miquel Just
- Department of Dermatology, Hospital de Figueres, Figueres, Girona, Spain
| | - Enric Llistosella
- Department of Dermatology, Hospital Universitari Dr. Josep Trueta, Girona, Spain
| | - M Elena Nogues
- Department of Dermatology, Hospital d'Igualada, Igualada, Barcelona, Spain
| | | | - Josep A Pujol
- Department of Dermatology, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Mireia Sabat
- Department of Dermatology, Hospital Parc Taulí, Sabadell, Spain
| | - Joan A Smandia
- Department of Dermatology, Hospital 2 de Maig, Barcelona, Spain
| | - Pedro Zaballos
- Department of Dermatology, Hospital de Santa Tecla, Tarragona, Spain
| | - Susana Puig
- Department of Dermatology, Hospital Clínic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain
| | - Rosa M Martí
- Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida & CIBERONC, Lleida, Spain
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14
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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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15
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Stratigos AJ, Fargnoli MC, De Nicolo A, Peris K, Puig S, Soura E, Menin C, Calista D, Ghiorzo P, Mandala M, Massi D, Rodolfo M, Del Regno L, Stefanaki I, Gogas H, Bataille V, Tucker MA, Whiteman D, Nagore E, Landi MT. MelaNostrum: a consensus questionnaire of standardized epidemiologic and clinical variables for melanoma risk assessment by the melanostrum consortium. J Eur Acad Dermatol Venereol 2018; 32:2134-2141. [PMID: 30098061 DOI: 10.1111/jdv.15208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/12/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Many melanoma observational studies have been carried out across different countries and geographic areas using heterogeneous assessments of epidemiologic risk factors and clinical variables. AIM To develop a consensus questionnaire to standardize epidemiologic and clinical data collection for melanoma risk assessment. METHODS We used a stepwise strategy that included: compilation of variables from case-control datasets collected at various centres of the MelaNostrum Consortium; integration of variables from published case-control studies; consensus discussion of the collected items by MelaNostrum members; revision by independent experts; addition of online tools and image-based charts; questionnaire testing across centres and generation of a final draft. RESULTS We developed a core consensus questionnaire (MelanoQ) that includes four separate sections: A. general and demographic data; B. phenotypic and ultraviolet radiation exposure risk factors and lifestyle habits; C. clinical examination, medical and family history; and D. diagnostic data on melanoma (cases only). Accompanying online tools, informative tables, and image-based charts aid standardization. Different subsections of the questionnaire are designed for self-administration, patient interviews performed by a physician or study nurse, and data collection from medical records. CONCLUSIONS The MelanoQ questionnaire is a useful tool for the collection and standardization of epidemiologic and clinical data across different studies, centres, cultures and languages. This will expedite ongoing efforts to compile high-quality data for pooled analyses or meta-analyses and offer a solid base for the design of clinical, epidemiologic and translational studies on melanoma.
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Affiliation(s)
- Alexander J Stratigos
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | | | - Arcangela De Nicolo
- Cancer Genomics Program, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Ketty Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - Susana Puig
- Dermatology Department, Melanoma Unit, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain.,Instituto de Investigacion Biomedica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Efthymia Soura
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Chiara Menin
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Donato Calista
- Dermatology Unit, Maurizio Bufalini Hospital, Cesena, Italy
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties, University of Genoa and Genetics of Rare Cancers, University Hospital Policlinico San Martino-IRCCS, Genoa, Italy
| | - Mario Mandala
- Unit of Melanoma, Department of Oncology and Hematology, Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy
| | - Daniela Massi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Monica Rodolfo
- Immunotherapy Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Irene Stefanaki
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - Helen Gogas
- Department of Internal Medicine, Laikon Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Veronique Bataille
- Department of Twin Research and Genetic Epidemiology, Kings College, London, UK
| | - Margaret A Tucker
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - David Whiteman
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - Maria Teresa Landi
- Human Genetics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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16
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Moreno-Ramírez D, Fernández-Orland A, Ferrándiz L. Disección ganglionar en el paciente de edad avanzada con melanoma. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.piel.2017.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Carrera C, Gual A, Díaz A, Puig-Butillé JA, Noguès S, Vilalta A, Conill C, Rull R, Vilana R, Arguis P, Vidal-Sicart S, Alós L, Palou J, Castel T, Malvehy J, Puig S. Prognostic role of the histological subtype of melanoma on the hands and feet in Caucasians. Melanoma Res 2017; 27:315-320. [PMID: 28296711 DOI: 10.1097/cmr.0000000000000340] [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] [Indexed: 11/26/2022]
Abstract
Acral melanoma (AM) is associated with a poor prognosis in part because of delayed diagnosis, but probably also because of other intrinsic characteristics of location. The aim of this study was to review the specific characteristics and outcome of AM in Caucasians. This was a cross-sectional retrospective clinical-pathological study of 274 patients identified with AM in the database of a referral unit in Europe from 1986 to 2010. The mean age of the patients was 56.6 (SD 17.7) years. 269 cases could be histologically classified and included in the study. In all, 222 (82.5%) were located on feet. According to melanoma subtype, 165 (61.3%) were acral lentiginous melanoma (ALM), 84 (31.2%) were superficial spreading melanoma (SSM), and 20 (7.5%) were nodular melanoma (NM). SSM patients were characterized by female predominance (77.4%), younger age, and classic melanoma-risk phenotype (fair skin and multiple nevi). Among the 198 invasive cases with a mean follow-up of 56.2 months, the mean (SD) Breslow's thickness was 3.1 (3.6) mm, being 1.4 (1.4) mm in SSM, 3.5 (4.1) mm in ALM and 4.9 (2.9) mm in NM (P<0.001). Ulceration was present in 33.3%, 2.9% in SSM, 38.6% in ALM, and 76.9% in NM (P<0.001). A total of 29.3% relapsed (7.3% of SSM, 35% of ALM and 55% of NM) and 24.2% died because of AM. In multivariate analysis, age at diagnosis, Breslow, and histopathological subtype were independent prognostic factors for both disease-free and AM-specific survival. The ALM and NM subtypes presented poorer outcome after weighting Breslow and age (P=0.02). Histological subtype of AM could have an impact on biological behavior, ALM and NM subtypes presenting a poorer prognosis after adjusting for age and Breslow's thickness.
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Affiliation(s)
- Cristina Carrera
- aMelanoma Unit, Department of Dermatology bMelanoma Unit, Department of Pathology cBiochemical and Molecular Genetics Service, Melanoma Unit, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) dRadiotherapeutic Oncology Service, Melanoma Unit eGeneral Surgery Service, Melanoma Unit fImaging Diagnostic Center, CDI (Radiology and Nuclear Medicine Services), Melanoma Unit, Hospital Clinic gBiomedical Research Center for Rare Diseases, CIBERER. Insituto de Salud Carlos III hMedicine Department, University of Barcelona, Barcelona, Spain
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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.
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Podlipnik S, Carrera C, Sánchez M, Arguis P, Olondo ML, Vilana R, Rull R, Vidal-Sicart S, Vilalta A, Conill C, Malvehy J, Puig S. Performance of diagnostic tests in an intensive follow-up protocol for patients with American Joint Committee on Cancer (AJCC) stage IIB, IIC, and III localized primary melanoma: A prospective cohort study. J Am Acad Dermatol 2016; 75:516-524. [PMID: 27183845 DOI: 10.1016/j.jaad.2016.02.1229] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/22/2016] [Accepted: 02/29/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is no international consensus on optimal follow-up schedules and which supplementary tests should be used after resection of a primary melanoma. OBJECTIVE We sought to analyze the performance of the follow-up components and identify procedures that detect melanoma metastasis earlier. METHODS This was a prospective cohort from 290 consecutive patients given a diagnosis of stage IIB, IIC, and III melanoma. Patients were followed up with an intensive protocol based on imaging studies (computed tomography of the chest, abdomen, and pelvis, and brain magnetic resonance imaging), periodic laboratory tests, regular physical examinations, and patient self-examinations. RESULTS A total of 2382 clinical examinations and 3069 imaging tests were performed. The patients completed 899.8 person-years of follow-up, with a median of 2.5 years. In all, 115 recurrences in 290 patients were recorded, of which computed tomography detected 48.3%; brain magnetic resonance imaging, 7.6%; laboratory test, 2.5%; physician, 23.7%; and patient, 17.8%. LIMITATIONS Patients with stage III melanoma were not systematically classified into subgroups and overall survival was not evaluated. CONCLUSION We observed that this intensive monitoring is appropriate for early detection of recurrence in stage IIB, IIC, and III melanoma. Prompt diagnosis of metastasis and the recent development of new therapeutic targets may improve overall survival.
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Affiliation(s)
- Sebastian Podlipnik
- Dermatology Department, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) on Rare Disease, Instituto de Salud Carlos III, Barcelona, Spain
| | - Cristina Carrera
- Dermatology Department, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) on Rare Disease, Instituto de Salud Carlos III, Barcelona, Spain
| | - Marcelo Sánchez
- Radiology Service, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Pedro Arguis
- Radiology Service, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Maria L Olondo
- Radiology Service, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ramon Vilana
- Radiology Service, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ramon Rull
- Surgery Department, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Sergi Vidal-Sicart
- Nuclear Medicine Service, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Antonio Vilalta
- Dermatology Department, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Carles Conill
- Radiotherapy Oncology, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Josep Malvehy
- Dermatology Department, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) on Rare Disease, Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Puig
- Dermatology Department, Melanoma Unit, Hospital Clinic, and Ititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red (CIBER) on Rare Disease, Instituto de Salud Carlos III, Barcelona, Spain.
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Tejera-Vaquerizo A, Descalzo-Gallego M, Otero-Rivas M, Posada-García C, Rodríguez-Pazos L, Pastushenko I, Marcos-Gragera R, García-Doval I. Skin Cancer Incidence and Mortality in Spain: A Systematic Review and Meta-Analysis. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.02.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Skin Cancer Incidence and Mortality in Spain: A Systematic Review and Meta-Analysis. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:318-28. [PMID: 26852370 DOI: 10.1016/j.ad.2015.12.008] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 12/21/2015] [Accepted: 12/22/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES The aim of this systematic review was to describe the incidence and mortality of basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma in Spain. MATERIAL AND METHODS We performed a search of the MEDLINE and Embase databases and reviewed articles from the Spanish Network of Cancer Registries (REDECAN) and the International Agency for Research on Cancer (IARC). The methodological quality of the studies was evaluated and statistical heterogeneity was measured using the I(2) index. A random-effects model was used to perform the meta-analysis because of the heterogeneity of the data. RESULTS Thirty-two papers were included in the systematic review. The crude incidence rate for basal cell carcinoma was 113.05 (95% CI, 89.03-137.08) cases per 100 000 person-years for the studies based on the registration methodology normally used by registries (in which only 1 tumor with histological confirmation is counted per person). However, the same incidence rate calculated on the basis of clinical and histologic criteria and counting tumors rather than individual patients was 253.23 (95% CI, 273.01-269.45) cases per 100 000 person-years. The incidence was 38.16 (95% CI, 31.72-39.97) cases per 100 000 person-years for squamous cell carcinoma, 8.76 (95% CI, 7.50-10.02) cases per 100 000 person-years for melanoma, and 0.28 (95% CI, 0.15-0.40) cases per 100 000 person-years for Merkel cell carcinoma. CONCLUSIONS The registration methodology normally used by cancer registries probably underestimates the incidence rates of basal cell and squamous cell carcinoma in Spain. The incidence rates of cutaneous melanoma and Merkel cell carcinoma are lower in Spain than in other European countries.
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Ribero S, Davies JR, Requena C, Carrera C, Glass D, Rull R, Vidal‐Sicart S, Vilalta A, Alos L, Soriano V, Quaglino P, Traves V, Newton‐Bishop JA, Nagore E, Malvehy J, Puig S, Bataille V. High nevus counts confer a favorable prognosis in melanoma patients. Int J Cancer 2015; 137:1691-8. [PMID: 25809795 PMCID: PMC4503475 DOI: 10.1002/ijc.29525] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/06/2015] [Indexed: 01/31/2023]
Abstract
A high number of nevi is the most significant phenotypic risk factor for melanoma and is in part genetically determined. The number of nevi decreases from middle age onward but this senescence can be delayed in patients with melanoma. We investigated the effects of nevus number count on sentinel node status and melanoma survival in a large cohort of melanoma cases. Out of 2,184 melanoma cases, 684 (31.3%) had a high nevus count (>50). High nevus counts were associated with favorable prognostic factors such as lower Breslow thickness, less ulceration and lower mitotic rate, despite adjustment for age. Nevus count was not predictive of sentinel node status. The crude 5- and 10-year melanoma-specific survival rate was higher in melanomas cases with a high nevus count compared to those with a low nevus count (91.2 vs. 86.4% and 87.2 vs. 79%, respectively). The difference in survival remained significant after adjusting for all known melanoma prognostic factors (hazard ratio [HR] = 0.43, confidence interval [CI] = 0.21-0.89). The favorable prognostic value of a high nevus count was also seen within the positive sentinel node subgroup of patients (HR = 0.22, CI = 0.08-0.60). High nevus count is associated with a better melanoma survival, even in the subgroup of patients with positive sentinel lymph node. This suggests a different biological behavior of melanoma tumors in patients with an excess of nevi.
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Affiliation(s)
- Simone Ribero
- Department of Twin Research & Genetic EpidemiologyKing's College LondonLondonUnited Kingdom
- Department of Medical Sciences, Section of DermatologyUniversity of TurinTurinItaly
- Department of DermatologyLondon North West Healthcare NHS Trust Northwick Park HospitalLondonUnited Kingdom
- Imperial College LondonLondonUnited Kingdom
| | - John R. Davies
- Section of Epidemiology and BiostatisticsLICAP, University of LeedsLeedsUnited Kingdom
| | - Celia Requena
- Department of DermatologyInstituto Valenciano De OncologıaValenciaSpain
| | - Cristina Carrera
- Department of DermatologyMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Daniel Glass
- Department of Twin Research & Genetic EpidemiologyKing's College LondonLondonUnited Kingdom
- Department of DermatologyLondon North West Healthcare NHS Trust Northwick Park HospitalLondonUnited Kingdom
- Imperial College LondonLondonUnited Kingdom
| | - Ramon Rull
- Department of SurgeryMelanoma UnitHospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Sergi Vidal‐Sicart
- Department of Nuclear Medicine ServiceMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Antonio Vilalta
- Department of DermatologyMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Lucia Alos
- Department of Pathology ServiceMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
| | - Virtudes Soriano
- Department of OncologyInstituto Valenciano De OncologıaValenciaSpain
| | - Pietro Quaglino
- Department of Medical Sciences, Section of DermatologyUniversity of TurinTurinItaly
| | - Victor Traves
- Department of PathologyInstituto Valenciano De OncologıaValenciaSpain
| | | | - Eduardo Nagore
- Department of DermatologyInstituto Valenciano De OncologıaValenciaSpain
| | - Josep Malvehy
- Department of DermatologyMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
- Instituto de Salud Carlos IIICIBER on Rare DiseasesBarcelonaSpain
| | - Susana Puig
- Department of DermatologyMelanoma Unit, Hospital Clinic & IDIBAPS, University of BarcelonaBarcelonaSpain
- Instituto de Salud Carlos IIICIBER on Rare DiseasesBarcelonaSpain
| | - Veronique Bataille
- Department of Twin Research & Genetic EpidemiologyKing's College LondonLondonUnited Kingdom
- Department of DermatologyWest Herts NHS TrustHertfordshireUnited Kingdom
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