Original articleEpidemiological changes in cutaneous melanoma: Retrospective study of 969 cases (1996–2010)Cambios epidemiológicos en el melanoma cutáneo: estudio retrospectivo de 969 casos (1996–2010)☆
Introduction
The incidence and mortality of cutaneous melanoma have increased in recent decades in numerous countries.1, 2 Melanoma affects individuals of all races and ethnic groups, although its incidence is closely linked to the color composition of the skin and varies according to the geographical area of residence. This cancer is responsible for more than 90% of deaths due to skin cancer.3, 4
The most important prognostic factor in these patients is still tumor thickness.5 The public campaigns aimed at encouraging the early diagnosis of melanoma appear to have led to an increase in the incidence of melanoma at the expense of a larger number of diagnoses of thin melanomas.6, 7 However, the proportion of patients with thick melanomas, which are associated with a poorer prognosis, has not declined.7, 8, 9
There is debate as to whether the increase in the incidence of melanoma is real or is due to the bias introduced by the greater number of melanomas diagnosed in early stages.10, 11, 12, 13, 14, 15, 16
There are several studies on the epidemiology of cutaneous melanoma in Spain, but very few analyze the epidemiological, clinical and histological characteristics of these patients and whether there are variations in the epidemiological profiles of patients with melanoma compared with previous decades.17, 18, 19, 20, 21, 22
We have conducted a descriptive epidemiological analysis of patients histologically diagnosed with cutaneous melanoma in healthcare area number 1 of the Autonomous Community of Madrid, assigned to the University General Hospital Gregorio Marañón (HGUGM) over a period of 15 years (1996–2010). We analyzed the changes noted in the epidemiological variables over the course of the study. To analyze the differences over the course of the study, the patients were divided into 3 groups according to the year of diagnosis (period 1: 1996–2000; period 2: 2001–2005, and period 3: 2006–2010).
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Material and methods
We analyzed data on all patients diagnosed by a histopathology report of cutaneous melanoma, primary or metastatic, of unknown origin, during the period between January 1, 1996 and December 31, 2010. It was irrelevant whether the initial diagnosis was made in the healthcare area corresponding to this hospital center or outside it, but the patients were nevertheless treated at HGUGM for this reason. These data were obtained primarily in the melanoma area of the Department of Dermatology at HGUGM
Results
A total of 969 patients were included. The overall epidemiological characteristics of these patients and the analysis of the differences observed during the study periods are shown in Table 1.
The mean age at the time of the diagnosis increased significantly over the course of the study (period 1996–2000: 57 years; period 2006–2010: 62 years; P < .001).
The location of the melanoma varied during the study periods, both overall and adjusted for gender. In males, the most common location was the
Discussion
The results obtained in our study in terms of the epidemiological variations observed in the patients with melanoma agree with those of other studies conducted on patients in Spain,17, 18, 19, 20, 21, 22, Italy,23, 24, 25 Germany,26, 27 and the United States.28 In general, we can see an increase in the annual incidence of melanoma in all of these studies, especially at the expense of facially located lentigo maligna melanomas in elderly individuals.18, 26 We also see an increase in the age at
Conflicts of interest
The authors have no conflicts of interest to declare.
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Please cite this article as: Avilés-Izquierdo JA, et al. Cambios epidemiológicos en el melanoma cutáneo: estudio retrospectivo de 969 casos (1996–2010). Rev Clin Esp. 2013:213:81–7.