Ródenas-Herranz Teresa, Rodriguez-Barranco Miguel, Petrova Dafina, Pérez-Gómez Beatriz, Ruiz-Villaverde Ricardo, Sánchez María-José
Dermatology Department, Hospital Universitario Clínico San Cecilio, Granada, Spain.
Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
Clin Exp Dermatol. 2025 Apr 24;50(5):981-993. doi: 10.1093/ced/llae516.
Cutaneous malignant melanoma (CMM) represents a global public health problem. Epidemiological studies about CMM trends tend to focus on single indicators or lack information about tumour characteristics that can help gain a more thorough understanding of CMM epidemiology.
To fill this gap, we studied CMM trends in incidence, mortality and survival over three decades and that considered sex, age and tumour characteristics.
Data were obtained for all patients with a new diagnosis of CMM during 1985-2017 from the population-based cancer registry in Granada (Southern Spain) and for deaths owing to CMM from the Ministry of Health of the Spanish government. Incidence, mortality and survival estimates were obtained according to sex, age group, anatomical site, histological type, Breslow index and Clark level. Observed and net survival were calculated for 1, 3 and 5 years using the Kaplan-Meier and Pohar-Perme methods, respectively. Log-linear jointpoint regression was used to assess temporal trends in age-standardized rates of incidence and mortality.
Between 1985 and 2017, 2446 patients aged ≥ 15 years were newly diagnosed with CMM. There was a significant increase in incidence, both in males and females (annual percentage of change 4.4% and 3.7%, respectively), mainly in superficial spreading and nodular melanomas, and more pronounced among those with < 1 mm Breslow index. Mortality rates increased, mainly driven by increases among males and individuals ≥ 65 years old. Nodular melanoma had the worst prognosis, with a 5-year net survival of 62.7% in the period 2008-2017 compared with survival > 90% for other subtypes. Overall 5-year net survival improved from 78.3% in 1985-1997 to 88.6% in 2008-2017, with a clear trend by Breslow index.
The incidence of melanoma in early stages in Southern Spain has increased over recent decades. This has been accompanied by noticeable improvements in mortality and survival, especially among younger age groups, suggesting the potential effectiveness of prevention strategies and new treatment regimens.
皮肤恶性黑色素瘤（CMM）是一个全球性的公共卫生问题。关于CMM趋势的流行病学研究往往侧重于单一指标，或者缺乏有助于更全面了解CMM流行病学的肿瘤特征信息。
为填补这一空白，我们研究了三十年来CMM在发病率、死亡率和生存率方面的趋势，并考虑了性别、年龄和肿瘤特征。
从西班牙南部格拉纳达基于人群的癌症登记处获取了1985 - 2017年期间所有新诊断为CMM患者的数据，并从西班牙政府卫生部获取了因CMM死亡的数据。根据性别、年龄组、解剖部位、组织学类型、Breslow指数和Clark分级获得发病率、死亡率和生存率估计值。分别使用Kaplan - Meier法和Pohar - Perme法计算1年、3年和5年的观察生存率和净生存率。采用对数线性联合点回归评估年龄标准化发病率和死亡率的时间趋势。
1985年至2017年期间，2446名年龄≥15岁的患者被新诊断为CMM。男性和女性的发病率均显著增加（年变化百分比分别为4.4%和3.7%），主要是在浅表扩散型和结节型黑色素瘤中，且在Breslow指数<1mm的患者中更为明显。死亡率上升，主要是由男性和65岁及以上个体的死亡率上升推动的。结节型黑色素瘤的预后最差，在2008 - 20l7年期间5年净生存率为62.7%，而其他亚型的生存率>90%。总体5年净生存率从1985 - 1997年的78.3%提高到2008 - 2017年的88.6%，且按Breslow指数有明显趋势。
近几十年来，西班牙南部早期黑色素瘤的发病率有所上升。与此同时，死亡率和生存率有显著改善，尤其是在较年轻年龄组中，这表明预防策略和新治疗方案可能有效。
