Abstract
BackgroundOver the past two decades, there has been a rising trend in malignant melanoma incidence worldwide. In 2008, Germany introduced a nationwide skin cancer screening program starting at age 35. The aims of this study were to analyse the distribution of malignant melanoma tumour stages over time, as well as demographic and regional differences in stage distribution and survival of melanoma patients.MethodsPooled data from 61 895 malignant melanoma patients diagnosed between 2002 and 2011 and documented in 28 German population-based and hospital-based clinical cancer registries were analysed using descriptive methods, joinpoint regression, logistic regression and relative survival.ResultsThe number of annually documented cases increased by 53.2% between 2002 (N = 4 779) and 2011 (N = 7 320). There was a statistically significant continuous positive trend in the proportion of stage UICC I cases diagnosed between 2002 and 2011, compared to a negative trend for stage UICC II. No trends were found for stages UICC III and IV respectively. Age (OR 0.97, 95% CI 0.97–0.97), sex (OR 1.18, 95% CI 1.11–1.25), date of diagnosis (OR 1.05, 95% CI 1.04–1.06), ‘diagnosis during screening’ (OR 3.24, 95% CI 2.50–4.19) and place of residence (OR 1.23, 95% CI 1.16–1.30) had a statistically significant influence on the tumour stage at diagnosis. The overall 5-year relative survival for invasive cases was 83.4% (95% CI 82.8–83.9%).ConclusionsNo distinct changes in the distribution of malignant melanoma tumour stages among those aged 35 and older were seen that could be directly attributed to the introduction of skin cancer screening in 2008.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2963-0) contains supplementary material, which is available to authorized users.
Highlights
Over the past two decades, there has been a rising trend in malignant melanoma incidence worldwide
Examinations for early detection of skin cancer were already offered in Germany since 1971 [5], Germany was the first country in Europe to introduce nationwide skin cancer screening in 2008 [6]
We examined the survival of melanoma patients, overall and stratified by age, sex, Union internationale contre le cancer (UICC) stage, ‘diagnosis during screening’ and place of residence
Summary
Over the past two decades, there has been a rising trend in malignant melanoma incidence worldwide. In 2008, Germany introduced a nationwide skin cancer screening program starting at age 35. Malignant melanoma occurs primarily in fair-skinned populations, with almost 80% of new cases worldwide occurring in North America, Europe, Australia and New Zealand [1]. It is the fourth most common cancer in Australia (age-standardised incidence rate 34.9 per 100 000, World Standard Population), the sixth most common cancer in North America (13.8 per 100 000) and the seventh most common cancer in the European Union (10.2 per 100 000), as well as in Germany (11.4 per 100 000) [2]. According to data reported for Germany, participation among those aged 35 years and older was around 30% between 2008 and 2010 [7, 8]
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