Σάββατο 9 Ιανουαρίου 2016

Disparities in melanoma incidence and mortality in South-Eastern Europe: Increasing incidence and divergent mortality patterns. Is progress around the corner?

Publication date: March 2016
Source:European Journal of Cancer, Volume 55
Author(s): Jelena Barbaric, Mario Sekerija, Dominic Agius, Daniela Coza, Nadya Dimitrova, Anna Demetriou, Chakameh Safaei Diba, Sultan Eser, Zivana Gavric, Maja Primic-Zakelj, Snezana Zivkovic, Miroslav Zvolsky, Freddie Bray, Jan Willem Coebergh, Ariana Znaor
IntroductionMost 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.MethodsWe 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.FindingsThe 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.InterpretationWhile 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.



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