Crocetti Emanuele, Mallone Sandra, Robsahm Trude Eid, Gavin Anna, Agius Domenic, Ardanaz Eva, Lopez Maria-Dolores Chirlaque, Innos Kaire, Minicozzi Pamela, Borgognoni Lorenzo, Pierannunzio Daniela, Eisemann Nora
UO Epidemiologia Clinica, Descrittiva e Registri - ISPO, Firenze, Italy.
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy.
Eur J Cancer. 2015 Oct;51(15):2179-2190. doi: 10.1016/j.ejca.2015.07.039. Epub 2015 Sep 26.
In Europe skin melanoma (SM) survival has increased over time. The aims were to evaluate recent trends and differences between countries and regions of Europe.
Relative survival (RS) estimates and geographical comparisons were based on 241,485 patients aged 15years and over with a diagnosis of invasive SM in Europe (2000-2007). Survival time trends during 1999-2007 were estimated using the period approach, for 213,101 patients. Age, gender, sub-sites and morphology subgroups were considered.
In European patients, estimated 5-year RS was 83% (95% confidence interval, CI 83-84%). The highest values were found for patients resident in Northern (88%; 87-88%) and Central (88%; 87-88%) Europe, followed by Ireland and United Kingdom (UK) (86%; 85-86%) and Southern Europe (83%; 82-83%). The lowest survival was in Eastern Europe (74%; 74-75%). Within regions the intercountry absolute difference in percentage points of RS varied from 4% (North) to 34% (East). RS decreased markedly with patients' age and was higher in women than men. Differences according to SM morphology and skin sub-sites also emerged. Survival has slightly increased from 1999 to 2007, with a small improvement in Northern and the most pronounced improvement in Eastern Europe.
SM survival is high and still increasing in European patients. The gap between Northern and Southern and especially Eastern European countries, although still present, diminished over time. Differences in stage distribution at diagnosis may explain most of the geographical differences. However, part of the improvement in survival may be attributed to overdiagnosis from early diagnosis practices.
在欧洲,皮肤黑色素瘤(SM)患者的生存率随时间推移有所提高。本研究旨在评估欧洲各国和各地区近期的趋势及差异。
基于241,485例年龄在15岁及以上、于2000 - 2007年在欧洲被诊断为侵袭性SM的患者,进行相对生存率(RS)估计和地理区域比较。采用时期法对1999 - 2007年期间的213,101例患者的生存时间趋势进行了估计。研究考虑了年龄、性别、肿瘤亚部位和形态学亚组等因素。
在欧洲患者中,估计的5年相对生存率为83%(95%置信区间,CI 83 - 84%)。居住在北欧(88%;87 - 88%)和中欧(88%;87 - 88%)的患者生存率最高,其次是爱尔兰和英国(UK)(86%;85 - 86%)以及南欧(83%;82 - 83%)。东欧患者的生存率最低(74%;74 - 75%)。在各区域内,各国相对生存率百分点的绝对差异从4%(北欧)到34%(东欧)不等。相对生存率随患者年龄显著下降,女性高于男性。根据皮肤黑色素瘤形态学和皮肤亚部位的差异也很明显。1999年至2007年期间生存率略有提高,北欧有小幅改善,东欧改善最为显著。
欧洲患者的皮肤黑色素瘤生存率较高且仍在上升。北欧与南欧尤其是东欧国家之间的差距虽然仍然存在,但随着时间推移有所缩小。诊断时分期分布的差异可能解释了大部分地理区域差异。然而,生存率的部分提高可能归因于早期诊断实践导致的过度诊断。