Incidence of Skin Melanoma in the Precarpathian Region. Overview of Trends of the Last Decade and Demonstration of Clinical Cases

Abstract

Introduction. Melanoma is a malignant tumour that develops from melanocytes and in most cases affects the skin. Although melanomas are usually highly pigmented, they can also be amelanotic. In the structure of mortality from skin cancers, melanoma takes the leading place with a rate of 90%.
 Even small tumours can metastasise. Under such conditions, early diagnosis is of paramount importance, as its main task is to detect and eliminate the primary lesion before it becomes deeply invasive.
 However, naked eye examination is limited to a sensitivity of about 75%, and is more effective when the tumour size is more than 5 mm. Among the additional examination methods, dermoscopy has become widespread. The technique has been introduced into the world dermatological practice for a long time and is actively used in Ukraine, demonstrating high efficiency at a relatively low cost of equipment.
 Materials and methods. Statistical data on 901 cases of newly diagnosed skin melanoma in the Ivano-Frankivsk region were obtained from the bulletins of the National Cancer Registry of Ukraine for the period 2012-2022.
 Results and discussion. There has been a gradual decline in the number of undetermined melanoma cases according to the TNM classification. The indicator has changed by more than 50 percentage points, with the lowest values at the turn of 2017-2018, and a subsequent increase of 10 percentage points until 2022.
 The number of reported cases of skin melanoma where the primary tumour distribution corresponds to the TI-TII category has increased, with a peak value of 92.7% as of 2017.  However, in the period 2019-2022, the trend changed dramatically. Since 2019, cases of skin melanoma diagnosed in the state of spread, which corresponds to category TIII, have prevailed – 51.1%, while cases of TI-TII accounted for 32.2%
 The global COVID pandemic that began in 2019 led to negative trends, contributed to the isolation of patients, and complicated their access to specialists. russia’s full-scale invasion of Ukraine in 2022 exacerbated this impact, which was reflected in the indicators of 2019-2022.
 The clinical cases from our practice in 2018 and 2021 were presented in the article.
 Conclusions. Melanoma is a malignant tumour with a high metastatic potential, with a better prognosis for recovery if diagnosed early. The increase in the number of registered cases of skin melanoma with primary tumour distribution in category TI-TII in 2013-2017 may indicate the effectiveness of measures aimed at promoting self-examination and timely treatment of patients for specialised care. The global COVID-19 pandemic and the full-scale russian invasion of Ukraine led to an increase in the proportion of melanomas diagnosed at the stage when the prevalence of the primary tumour corresponds to category TIII. It is necessary to resume measures that have had a positive impact on the health of residents of the Precarpathian region.