Highlights
- •Melanoma incidence rates in South-Eastern Europe were uniformly increasing over the 2000–2010 period.
- •Incidence rates were higher in men than in women at middle and older ages in most countries.
- •Trends in mortality rates diverged but were less favourable than in North-Western Europe.
- •Empowering cancer registration in the region will be essential for monitoring progress.
Abstract
Introduction
Most countries in South-Eastern Europe (SEE) have lower incidence, but higher mortality
rates of malignant melanoma (MM) of the skin compared to North-Western Europe (NWE).
We explored trends in MM incidence and mortality in SEE countries by sex and age and
compared them with the trends in NWE.
Methods
We obtained data on incident cases and deaths from MM (ICD-10 code C43) from 11 population-based
cancer registries in Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic,
Malta, Romania, Serbia, Slovakia, Slovenia and Turkey. We calculated age-specific
rates for 25–49 (‘young’), 50–69 (‘middle aged’) and 70+ years (‘older’) and estimated
the average annual percent of change in incidence and mortality trends 2000–2010 according
to age group and sex, using joinpoint regression analysis.
Findings
The incidence rates of MM across the region were uniformly increasing. Significant
increases in mortality rates were observed in middle aged men in Serbia and Bulgaria,
middle aged women in Slovenia, older men in the Czech Republic, Serbia and Turkey,
and older women in Slovenia and Serbia.
Interpretation
While MM incidence rates were still increasing across SEE, mortality trends diverged
and were less favourable than in NWE. Empowering cancer registration and improving
the quality of incidence and mortality data will be essential for monitoring progress
in MM control. In the context of prevention of melanoma, disparities in early detection
appear to be widening the gap between SEE and NWE, while the provision of care to
patients with advanced disease is likely to prove a challenge for regional healthcare
budgets.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of CancerAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cancer incidence in five continents, vol. X. 2013 (Lyon)
- Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi.Eur J Cancer. 2005; 41: 28-44
- Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure.Eur J Cancer. 2005; 41: 45-60
- Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors.Eur J Cancer. 2005; 41: 2040-2059
- Sex is an independent prognostic indicator for survival and relapse/progression-free survival in metastasized stage III to IV melanoma: a pooled analysis of five European organisation for research and treatment of cancer randomized controlled trials.J Clin Oncol. 2013; 31: 2337-2346
- Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.Int J Cancer. 2015; 136: E359-E386
- GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC CancerBase No. 11.2013 ([Internet])
- International trends in the incidence of malignant melanoma 1953–2008-are recent generations at higher or lower risk?.Int J Cancer. 2013; 132: 385-400
- Changing epidemiology of malignant cutaneous melanoma in Europe 1953–1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia.Int J Cancer. 2003; 107: 119-126
- Cancer incidence and mortality patterns in South Eastern Europe in the last decade: gaps persist compared with the rest of Europe.Eur J Cancer. 2013; 49: 1683-1691
European Parliament resolution of 10th April 2008 on combating cancer in the enlarged European Union (2009/C 247 E/04). Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=uriserv:OJ.CE.2009.247.01.0011.01.ENG [accessed 23.06.14].
Treaty establishing the European Community (Amsterdam consolidated version) Part Three: Community policies. Title XIII: Public health. Article 152. Available from: http://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX:11997E152 [accessed 09.03.15].
European Commission website. Available from: http://ec.europa.eu/enlargement/countries/check-current-status/index_en.htm [accessed 14.04.14].
- Incidence and mortality trends of melanoma in Croatia.Croat Med J. 2012; 53: 135-140
- Melanoma incidence and mortality in Europe: new estimates, persistent disparities.Br J Dermatol. 2012; 167: 1124-1130
EUROCOURSE Project website. Available from: http://www.eurocourse.org/ [accessed 14.04.14].
- Uses of cancer registries for public health and clinical research in Europe: results of the European Network of Cancer Registries survey among 161 population-based cancer registries during 2010–2012.Eur J Cancer. 2015; 51: 1039-1049
- Joinpoint Regression Program, Version 4.0.4. Statistical Methodology and Applications Branch, Surveillance Research Program. National Cancer Institute, May 2013
- Permutation tests for joinpoint regression with applications to cancer rates.Stat Med. 2000; 19 (correction 2001;20(4):655): 335-351
Hammarström H, Forkel R, Haspelmath M, Bank S. Glottolog 2.4. Leipzig: Max Planck Institute for Evolutionary Anthropology. Available from: http://glottolog.org [accessed 06.10.14].
- Data provided on request through personal communication.October 24, 2014 (Available from:)
- Euromelanoma: a dermatology-led European campaign against nonmelanoma skin cancer and cutaneous melanoma. Past, present and future.Br J Dermatol. 2012; 167: 99-104
- Survival of patients with skin melanoma in Europe increases further: results of the EUROCARE-5 study.Eur J Cancer. 2015; 51: 2179-2190
World Bank 2010. Available from: http://data.worldbank.org/indicator/SH.XPD.PCAP/countries [accessed 6.10.14].
- Lower incidence rates but thicker melanomas in Eastern Europe before 1992: a comparison with Western Europe.Eur J Cancer. 2004; 40: 1045-1052
- Trends in incidence and predictions of cutaneous melanoma across Europe up to 2015.J Eur Acad Dermatol Venereol. 2014; 28: 1170-1178
- Cancer mortality in Europe, 2005–2009, and an overview of trends since 1980.Ann Oncol. 2013; 24: 2657-2671
- The forthcoming inexorable decline of cutaneous melanoma mortality in light-skinned populations.Eur J Cancer. 2015; 51: 869-878
- The validity and practicality of sun-reactive skin types I through VI.Arch Dermatol. 1988; 124: 869-871
EUROSUN project website. Available from: http://www.eurosun-project.org/ [accessed 23.06.14].
- The Euromelanoma skin cancer prevention campaign in Europe: characteristics and results of 2009 and 2010.J Eur Acad Dermatol Venereol. 2011; 25: 1455-1465
- Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE–5-a population-based study.Lancet Oncol. 2014; 15: 23-34
- Epidemiologija kožnega raka (Epidemiology of skin cancer, in Slovenian).in: Luzar B. Novosti v dermatopatologiji (Update on dermatopathology, in Slovenian). Proceedings of XL. memorialni sestanek profesorja Janeza Plečnika, Ljubljana 3–4 December 2009. Ljubljani Inštitut za Patol. Med. Fak., 2009 ([COBISS.SI-ID 26570201])
- Skin biopsy rates and incidence of melanoma: population based ecological study.BMJ. 2005; 331: 481
- Increasing time trends of thin melanomas in The Netherlands: what are the explanations of recent accelerations?.Eur J Cancer. 2015; 51: 2833-2841
- Cancer incidence in five continents, vol. IX. 2007 (Lyon)
- Power analysis to detect time trends on population-based cancer registries data: when size really matters.Eur J Cancer. 2015; 51: 1082-1090
- Melanoma: smart therapeutic strategies in immuno-oncology.Nat Rev Clin Oncol. 2014; 11: 181-182
- Cutaneous melanoma.Lancet. 2014; 383: 816-827
- Pooled analysis of long-term survival data from phase II and phase III trials of ipilimumab in unresectable or metastatic melanoma.J Clin Oncol. 2015; 33: 1889-1894
- Genetic alterations and personalized medicine in melanoma: progress and future prospects.J Natl Cancer Inst. 2014; 106 (djt435)
- Improved overall survival in melanoma with combined dabrafenib and trametinib.N Engl J Med. 2015; 372: 30-39
- The advantage of women in cancer survival: an analysis of EUROCARE-4 data.Eur J Cancer. 2009; 45: 1017-1027
Article info
Publication history
Published online: January 08, 2016
Accepted:
November 18,
2015
Received in revised form:
October 23,
2015
Received:
August 14,
2015
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
