Time trends of cutaneous melanoma in Queensland, Australia and Central Europe

• Published in: Cancer Vol. 89; no. 6; pp. 1269 - 1278
• Main Authors: Garbe, Claus, McLeod, G. Roderick C., Buettner, Petra G.
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 15-09-2000; Wiley-Liss
• Subjects: Adult; Age Factors; Aged; Austria - epidemiology; Biological and medical sciences; cancer registry; Cell Division - physiology; clinical and pathologic characteristics; cutaneous melanoma; Dermatology; Epidemiology - trends; Female; Germany - epidemiology; Humans; Incidence; Male; Medical sciences; Melanoma - epidemiology; Melanoma - pathology; Middle Aged; Neoplasm Invasiveness; Prognosis; prognostic factors; Queensland - epidemiology; Risk Factors; Sex Factors; Skin; Skin Neoplasms - epidemiology; Skin Neoplasms - pathology; Switzerland - epidemiology; time trend; Tumors of the skin and soft tissue. Premalignant lesions; Austria; Europe; Australia; Central Europe; Switzerland; Germany; Oceania; Queensland; Thickness; Human; Pathology; Skin disease; Histopathology; Prognosis; Melanoma; Histological type; Skin; Time; Malignant tumor
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(20000915)89:6<1269::AID-CNCR11>3.0.CO;2-C

BACKGROUND
The objective of this study was to describe recent developments in cutaneous melanoma from the German speaking countries in Europe (Germany, Austria, and Switzerland) and from Queensland, Australia.
METHODS
All incident invasive cutaneous melanoma cases recorded between 1986 and 1996 by the Queensland Melanoma Register and by the Central Malignant Melanoma Registry of the German Dermatological Society were included in the analysis. Weighted linear trend analyses were performed to assess significant changes over the years using yearly sample sizes as weights.
RESULTS
In Central Europe, the median tumor thickness decreased from 1.2 mm in 1986 to 0.8 mm in 1996 (P < 0.001), whereas it varied insignificantly between 0.5 mm and 0.6 mm in Queensland. The percentage of patients with Clark Level II invasion increased significantly in Queensland (P < 0.001; 1996, 61.1%) and in Central Europe (P = 0.041; 1996, 24.5%). The percentage of superficial spreading melanomas rose in Central Europe (P = 0.043; 1996, 64.4%), whereas it decreased slightly in Queensland (P = 0.032; 1996, 75%). In Queensland and in Central Europe, younger people and women presented more frequently with thinner melanomas (≤ 0.75 mm).
CONCLUSIONS
In both Central Europe and Queensland, trends toward thinner and less invasive melanomas were observed between 1986 and 1996, although the median tumor thickness decreased significantly only for Central European data. Men and elderly individuals should be the focus of health‐promotion activities, because they tended to present on average with thicker and prognostically poorer melanomas. Cancer 2000;89:1269–78. © 2000 American Cancer Society.
In both Central Europe (Germany, Austria, and Switzerland) and Queensland, Australia, trends toward thinner and less invasive melanomas were observed between 1986 and 1996, although the median tumor thickness decreased significantly only for Central European data. Health promotion activities concerning skin carcinoma should target men and elderly people, because those groups consistently were identified as presenting with more advanced melanomas.