Bueno-Molina Rocío C, Sendín-Martín Mercedes, Hernández-Rodríguez Juan-Carlos, Cayuela Lucía, Cayuela Aurelio, Pereyra-Rodríguez José-Juan
Department of Dermatology, Virgen del Rocío University Hospital, Seville, Spain.
Department of Internal Medicine, Hospital Severo Ochoa, Leganés, Spain.
Int J Dermatol. 2025 Nov;64(11):2054-2063. doi: 10.1111/ijd.17851. Epub 2025 May 14.
Cutaneous melanoma is the most aggressive form of skin cancer. Although some studies have explored the epidemiology of melanoma in Europe, there is limited data on its spatial distribution.
A longitudinal ecological study was conducted to analyze melanoma incidence and mortality from 2017 to 2021 using data from the Global Burden of Disease database. Cases were identified using the International Classification of Diseases (ICD)-9 and ICD-10 codes for both sexes across four European geographical regions, excluding Russia. Age-standardized incidence and mortality rates were calculated. A distance-based spatial weights matrix was generated using GeoDa software to define neighborhood structure. Hotspot analysis of spatial clusters was conducted using the Getis-Ord Gi* statistic. Additionally, the mortality-to-incidence ratio was calculated.
Between 2017 and 2021, a total of 606,448 new melanoma cases were diagnosed in Europe. Both sexes exhibited higher incidence and mortality rates in Northern Europe. All rates were consistently lower in women. For both sexes, incidence hotspots were identified in Sweden, Denmark, the Netherlands, and the United Kingdom. In contrast, mortality hotspots are primarily observed in the Nordic countries, as well as in Eastern Europe. Incidence coldspots are predominantly found in southeastern Europe, whereas mortality coldspots are primarily concentrated in Spain and Portugal. The overall mortality-to-incidence ratio in Europe remained stable during the period, with an evident east-west gradient and higher mortality relative to incidence observed in Eastern Europe.
This analysis reveals distinct geographical patterns, characterized by a north-south gradient in incidence and mortality. In contrast, the mortality-to-incidence ratio follows an east-west gradient, highlighting significant disparities in healthcare access.
皮肤黑色素瘤是最具侵袭性的皮肤癌形式。尽管一些研究探讨了欧洲黑色素瘤的流行病学，但关于其空间分布的数据有限。
进行了一项纵向生态研究，使用全球疾病负担数据库的数据分析2017年至2021年期间黑色素瘤的发病率和死亡率。通过国际疾病分类（ICD）-9和ICD-10编码在四个欧洲地理区域（不包括俄罗斯）识别男女病例。计算年龄标准化发病率和死亡率。使用GeoDa软件生成基于距离的空间权重矩阵来定义邻域结构。使用Getis-Ord Gi*统计量对空间集群进行热点分析。此外，计算死亡率与发病率之比。
2017年至2021年期间，欧洲共诊断出606,448例新的黑色素瘤病例。北欧的男性和女性发病率和死亡率均较高。女性的所有发病率均持续较低。对于男性和女性，在瑞典、丹麦、荷兰和英国发现了发病率热点。相比之下，死亡率热点主要出现在北欧国家以及东欧。发病率冷点主要位于东南欧，而死亡率冷点主要集中在西班牙和葡萄牙。在此期间，欧洲的总体死亡率与发病率之比保持稳定，呈现出明显的东西梯度，东欧的死亡率相对于发病率更高。
该分析揭示了不同的地理模式，其特征是发病率和死亡率呈南北梯度。相比之下，死亡率与发病率之比呈东西梯度，突出了医疗服务可及性的显著差异。
