Skin Melanoma Incidence Research Articles

Age-sex characteristics of the incidence of melanoma of the skin in the Samara region

Currently, melanoma of the skin is an urgent medical and social problem. In recent decades, there has been an increase in the incidence and prevalence in the world and in the Russian Federation. According to the results of an epidemiological study, an increase in the prevalence and incidence of skin melanoma in the Samara region in 2014–2022 was revealed. An in-depth calculation and analysis of five-year sex and age indicators of the incidence of melanoma of the skin was carried out. It has been established that the incidence rate in women generally prevails over the incidence rate of men in almost every five-year age group. With increasing age (especially in the group of 70 years and older), the incidence becomes higher in both men and women. The fact of a significant increase in the incidence of skin melanoma in 2022 compared to 2014 in young working ages is alarming. The results obtained indicate the need to increase the effectiveness of targeted preventive measures to reduce the prevalence and incidence of skin melanoma, taking into account age and sex characteristics.

White horses - non-coding sequences drive premature hair greying and predisposition to melanoma.

The Grey allele in horses is causing premature hair greying and susceptibility to melanoma. The causal mutation is a 4.6 kb tandem duplication in intron 6 of the Syntaxin 17 gene. A recent study demonstrated that the most common allele at the Grey locus (G3) involves three tandem copies of this sequence, whilst a more rare allele (G2) has two tandem copies and the wild-type allele (G1) only one copy. The G3 allele is causing fast greying and high incidence of skin melanoma, whereas the G2 allele is causing slow greying and no obvious increase in melanoma incidence. Further somatic copy number expansion has been documented in melanoma tissue from Grey horses. Functional studies showed that this intronic sequence acts as a weak melanocyte-specific enhancer that becomes substantially stronger by the copy number expansion. The Grey mutation is associated with upregulated expression of both Syntaxin 17 and the neighbouring NR4A3 gene in Grey horse melanomas. It is still an open question which of these genes is most important for the phenotypic effects or if causality is due to the combined effect of upregulation of both genes. Interestingly, RNAseq data in the Human Protein Atlas give support for a possible role of NR4A3 because it is particularly upregulated in human skin cancer, and it belongs to a cluster of genes associated with skin cancer and melanin biosynthesis. The Grey mutation and its association with melanoma provide a possibility to study the path to tumour development in numerous Grey horses carrying exactly the same predisposing mutation.

EPIDEMIOLOGICAL SITUATION OF SKIN CANCER AND MELANOMIA
 IN THE REPUBLIC OF KAZAKHSTAN IN 2012-2022

Relevance: Skin cancer, including melanoma, is a major health problem and one of the most common cancers in the world.
 The study aimed to obtain a complete epidemiological picture of skin cancer and melanoma in the Republic of Kazakhstan for 11 years,
 including analysis of data for 2022, considering various parameters such as age, sex, ethnicity, region, and tumor type.
 Methods: The study used data from patients registered in the national cancer registry of the Republic of Kazakhstan from 2012 to 2022,
 diagnosed with skin carcinoma and skin melanoma (ICD-10 code: C44-C43). The number of skin carcinomas and melanoma cases is presented as absolute and crude rates per 100,000 population. Absolute standardized morbidity and mortality rates were calculated using the world
 standard (World).
 Results: At the end of 2022, 19,714 and 2,689 patients were diagnosed with “Skin Cancer” or “Skin Melanoma” in the Republic of Kazakhstan, respectively. From 2012 to 2022, the incidence of skin cancer increased by 24% and melanoma by 15%. In 2022, the incidence of skin
 cancer and melanoma was higher among women by 24% and 26%, respectively. Mortality from skin cancer is in 23rd place, from melanoma in
 21st place. Mortality rates from skin cancer and melanoma were 0.5 and 0.7 per 100 thousand population, respectively. The peak incidence of skin cancer in 2022 was observed in the age group 65-74 years (36%), and mortality in the age groups 65-74 and 75-84 years (17% each). The
 peak incidence of skin melanoma in 2022 was observed in the age groups 55-64 years and 65-74 years (24% and 25%), and mortality in the
 groups 45-54 years and 35-44 years (14% and 10%).
 Conclusion: There has been a steady increase in the incidence of skin cancer and melanoma, which indicates the seriousness of this problem in the country and underlines the need for further measures to prevent, diagnose and treat skin cancer and melanoma in the Republic of
 Kazakhstan. It should be remembered that many cases of skin cancer can be prevented with simple precautions.

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

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.

Aggregation-induced emission photosensitizer microneedles for enhanced melanoma photodynamic therapy.

The incidence and mortality rates of skin melanoma have been increasing annually. Photodynamic therapy (PDT) enables effective destruction of tumor cells while minimizing harm to normal cells. However, traditional photosensitizers (PSs) suffer from photobleaching, photodegradation and the aggregation-caused quenching (ACQ) effect, and it is challenging for light to reach the deep layers of the skin to maximize the efficacy of PSs. Herein, we developed dissolving microneedles (MNs) loaded with PSs of TPE-EPy@CB[7] through supramolecular assembly. The PSs effectively enhanced the type-I reactive oxygen species (ROS) generation capacity, with a concentration of 2 μM possessing nearly half of the tumor cell-killing ability under 10 min white light irradiation. The MNs were successfully pierced into the targeted site for precise drug delivery. Additionally, the conical structure of the MNs, as well as the lens-like structure after dissolution, facilitated the transmission of light in the subcutaneous tissue, achieving significant inhibition of tumor growth with a tumor suppression rate of 97.8% and no systemic toxicity or side effects in melanoma mice. The results demonstrated the potent melanoma inhibition and biosafety of this treatment approach, exhibiting a new and promising strategy to conquer malignant melanoma.

News in immunotherapy for metastatic melanoma: prolgolimab in clinical practice (authors' experience)

The incidence of skin melanoma is growing globally and in Russia. Also, the proportion of patients with advanced skin melanoma prevails. Introduction into clinical practice of a novel group of immunological drugs (anti-CTLA4 and anti-PD-1) for metastatic melanoma increased the time to disease progression and patients' life expectancy. Prolgolimab is a PD-1 inhibitor, a new domestic drug that is effective and safe in treating metastatic melanoma. The article presents authors' experience with prolgolimab. When used in the first-line treatment of metastatic melanoma, this drug achieved long-term stabilization of the disease. The drug showed good tolerability, including in patients with severe comorbidity.

Primary multiple malignant skin tumors: melanoma and basal cell carcinoma

The incidence of skin melanoma in the world is growing every year. Despite advances in diagnostics, the identification of the primary focus of melanoma in some cases is still difficult. The natural course sometimes manifests only with the appearance of melanoma metastases, which can mimic other diseases. Patient S., 52 years old, was admitted to the FCBRN of FMBA of Russia with complaints on periodic systemic dizziness, headaches of a pressing nature, episodes of speech impairment over the past three months. According to the brain MRI-scan results, a volumetric formation of the left frontal lobe was revealed. Upon examination, two non-pigmented lesions were found on the skin of the scalp and forehead. Due to the presence of focal neurological symptoms, it was decided to remove the brain tumor using neurophysiological monitoring and the scalp skin lesion, with histological verification. Morphological diagnosis of the removed brain tumor was a metastasis of amelanotic epithelioid melanoma. The skin lesion was basal cell carcinoma. Thus, the patient had primarily multiple malignant tumors: metastatic melanoma and basal cell carcinoma. The primary focus of melanoma could not be identified by available noninvasive research methods. The patient was referred to an oncologist to decide on the tactics of further examination and treatment. To date, the patient has been treated according to the scheme sh0876 1 line 1 course of pembrolizumab 400 mg IV, cycle 42 days.

Assessing the effect of environmental and socio-economic factors on skin melanoma incidence: an island-wide spatial study in Gran Canaria (Spain), 2007–2018

IntroductionSkin melanoma incidence has risen in the last decades becoming a major public health problem in many regions of the world. Geographic variation of rates is not well understood.PurposeTo assess the spatial distribution of skin melanoma in Gran Canaria Island (Canary Islands, Spain) and to evaluate the role of environmental, socio-economic, and demographic factors in this distribution.MethodsWe performed a small-area study with disease mapping at the census-tract level (CT) in Gran Canaria between 2007 and 2018. After testing for spatial autocorrelation, we integrated individual-level health data with census-based demographic and socio-economic indicators, and satellite-based environmental data. Finally, we assessed the role of demographic, socio-economic and environmental factors on skin melanoma incidence using a Bayesian analytical framework, with options for non-spatial and spatial random effects.Results1058 patients were diagnosed with invasive skin melanoma in the study period and geolocated to a CT (number of CT in Gran Canaria = 565). We found evidence of global spatial autocorrelation in skin melanoma incidence (Moran’s I = 0.09, pseudo p-value = 0.001). A few hotspots were detected, fundamentally in urban northern tracts. A radial pattern of high values was also observed in selected ravines with historical isolation. Multivariable conditional autoregressive models identified urbanicity, percent of females, and a high socio-economic status as risk factors for disease. Solar radiation did not show a significant role.ConclusionUrbanicity and a high socio-economic status were identified as the main risk factors for skin melanoma. These associations might reflect differential melanoma susceptibilities or be explained by health inequalities in detection. This study also uncovered high-risk areas in particular ravines. Future targeted research in these regions might help better understand the role of genetic and toxic factors in melanoma pathogenesis.

Identification of Cancerous Cell from Noisy Images

Abstract: Over the last decades, the incidence of skin cancer, melanoma and non-melanoma,has increased at a continuous rate. In particular for melanoma, the deadliest type of skin cancer, early detection is important to increase patient prognosis. Recently, deep neural networks (DNNs) have become viable to deal with skin cancer detection. In this work, we present a smartphone-based application to assist on skin cancer detection. This application is based on a Convolutional Neural Network (CNN) trained on clinical images and patients demographics, both collected from smartphones. Also, as skin cancer datasets are imbalanced, we present an approach, based on the mutation operator of Differential Evolution (DE) algorithm,to balance data. In this sense, beyond provides a flexible tool to assist doctors on skin cancer screening phase, the method obtains promising results with a balancedaccuracy of 85% and a recall of 96%. Index Terms—skin cancer detection, smartphone application, deep learning, convolutional neural network

The Principles of Examination of Patients with Detected Melanoma Suspected Skin Neoplasm in the Primary Health Care Stage

Currently, in the structure of mortality in the Russian Federation and a number of other countries, oncological diseases occupy a leading position among other causes. Melanoma of the skin is one of the most aggressive malignant tumors, with rapid progression, often leading to death in a fairly short time. Early detection and rationally organized refferral of patients with diagnosed skin melanoma in primary health care settings is aimed at reducing morbidity and mortality from malignant diseases, and improving the quality of life of patients. Research results suggest that the increased incidence of skin melanoma is due to both overdiagnosis. and an increase in the alertness of doctors and the population in relation to pigmented skin formations. The article discusses the proven risk factors for the development of skin melanoma, since this disease is potentially reversible. Attention is paid to modern clinical methods for predicting the course of skin melanoma. The review article examines computer-based methods for screening and diagnosing skin melanoma, applicable in primary health care settings. A separate section is devoted to dermatoscopy or epiluminescence microscopy, which refers to the study of pigmented skin lesions using surface microscopy. A list of studies is presented in case of suspicion of a malignant neoplasm of the skin / melanoma of the skin in a patient who sought medical help at a medical and prophylactic institution. The significance of the criteria of the ABCDE algorithm, the “Argenziano” algorithm in the study of pigmented skin lesions with further analysis of the results by artificial intelligence for decision-making is discussed.

Ранняя диагностика меланомы: актуальная задача современного клинициста

Authors assessed the incidence of skin melanoma during outpatient consultations at the Consultation and Diagnostic Center of the Main Military Clinical Hospital named after academician N.N. Burdenko. During the period from 2019 to 2020, the authors diagnosed 68 patients with skin melanoma with stages ranging as follows: in situ ― 3 (4.4%) cases, stage IA ― 11 (16.2%) cases, IB ― 13 (19.1%) cases, IIA ― 11 (16.2%) cases, IIB ― 6 (8.8%) cases, IIC ― 9 (13.2%) cases, IIIA ― 3 (4.4%) cases, IIIB ― 4 (5.9%) cases, IIIC ― 3 (4.4%) cases, IV ― 5 (7.4%) cases. The necessity to apply the knowledge about the clinical and dermoscopic features of this malignant disease to diagnose skin melanoma, as well as exceptional prognostic significance of early detection of skin melanoma, were demonstrated.

Cancer incidence among musicians: 45 years of follow-up in four Nordic countries

Background There are studies suggesting that participation in musical activities may protect from cancer. On the other hand, some musicians have a lifestyle that might increase the risk of cancer. The objective of this study was to assess the cancer pattern of musicians in four Nordic countries. Material and methods This study combines census and cancer registry data from 1961 to 2005 for 13 million people from Finland, Iceland, Norway, and Sweden. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for entire national populations used as reference rates. Results There were 11,401 male and 3105 female musicians with 2039 cancer cases. The SIR for all sites combined was 1.02 (95% confidence interval 0.97–1.07) in men and 1.04 (0.94–1.15) in women. In male musicians, there were statistically significant excesses in oropharyngeal cancer (4.36, 2.73–6.60), esophageal cancer (2.08, 1.51–2.81), liver cancer (1.81, 1.26–2.52), and skin melanoma (1.40, 1.10–1.75). The risk was decreased in lip cancer (0.13, 0.02–0.48), stomach cancer (0.66, 0.50–0.82), and lung cancer (0.77, 0.65–0.90). In female musicians, there were no statistically significant SIRs in any of the cancer types studied, but the risk of breast cancer was significantly elevated in the age category of 70+ (1.52, 1.04–2.15). The overall SIR was stable over the 45 year period of observation, but strong decreases were observed in the SIRs of esophageal cancer, liver cancer, laryngeal cancer, and skin melanoma. Conclusion Musicians have characteristics of indoor workers such as low incidence of lip cancer and high incidence of skin melanoma. The low incidence of lung cancer suggests that the prevalence of smoking among musicians is lower than in the general population while the elevated risk of alcohol-related cancer types suggest that drinking is likely more common among musicians. The cancer risk for all sites combined is still similar to that of the general population in the four countries studied.

Living alone as a risk factor for cancer incidence, case-fatality and all-cause mortality: A nationwide registry study

Lack of social contacts has been associated with an increased risk of cancer mortality, but it is not known whether living alone increases the risk of cancer incidence or case fatality. We examined the association between living alone with cancer incidence, case-fatality and all-cause mortality in eight most common cancers. All patients with their first cancer diagnosis in 2000–2017 were identified from the nationwide Finnish Cancer Registry. Information on living arrangements was derived from Statistics Finland. The incidence analyses were conducted using Poisson regression. The total Finnish population served as the population at risk. Fine-Gray model was used to estimate case-fatality and Cox proportional regression model all-cause mortality. In men, we found an association between history of living alone and excess lung cancer incidence but living alone seemed to be associated with lower incidence of prostate cancer and skin melanoma. In women, living alone was more consistently associated with higher incidence of all studied cancers. Cancer patients living alone had an 11%–80% statistically significantly increased case-fatality and all-cause mortality in all studied cancers in men and in breast, colorectal and lung cancer in women. Living alone is consistently associated with increased cancer incidence risk in women but only in some cancers in men. Both men and women living alone had an increased risk of all-cause mortality after cancer diagnosis.

Trends in Incidence and Mortality of Skin Melanoma in Lithuania 1991–2015

Background. We aimed to investigate age-specific and sex-specific incidence trends of melanoma in Lithuania from 1991 to 2015. Methods. Analysis was based on data from the population-based Lithuanian Cancer Registry database for 1991–2015, and 6024 cases of skin melanoma were identified. Age-adjusted rates (ASRs) by sex and age group were calculated. Adjustment for ASRs was done using the old European standard population, where a total of three age groups were considered: 0–39, 40–59 and 60+. Additionally, the annual percent change (APC) was calculated, and 95% confidence intervals for APC were calculated. Results. Between 1991 and 2015, the overall melanoma rates increased by an annual percent change (APC) of 3.9% in men (95% CI, 3.6–4.1%) and 2.3% in women (95% CI, 2.1–2.5%). The highest incidences of new cutaneous melanoma cases were observed between old adults (60+) of both sexes, while the lowest incidence rates were observed in the young adult group (up to 39 years old), with the lowest APC (1.6% in males and 0.4% in females). The overall number of melanoma deaths during 1991 and 2015 increased from 64 to 103 deaths per year, and the age-standardized rate (ASR) increased 1.3 times (from 1.8 to 2.4). Conclusions. The incidence and mortality of skin melanoma seem to be increased in all age groups. These trends indicate that skin protection behavior is not sufficient in our population and more efforts need to be taken in order to decrease incidence and mortality rates.

The incidence of skin melanoma in Gran Canaria (Canary Islands, Spain) is lower than expected in Southern Europe despite high-risk environmental conditions: an island-wide cross-sectional study

The Canary Islands are a leading European touristic destination. The ultraviolet index (UVI) in the region is the highest in Spain, and similar to indexes registered in Australia and New Zealand, which hold the highest incidence of skin melanoma worldwide. Yet according to cancer registry data, the incidence in the Canary Islands in the late 1990s was the lowest in Spain (among the lowest in Europe) and about six times lower than in New Zealand. To analyze the incidence rates of skin melanoma in Gran Canaria island between 2007 and 2018. The study was based in the two centres of the Canary Islands' Healthcare Service centralizing melanoma care in Gran Canaria. We analyzed crude and age-standardized (ASR) incidence rates of invasive cutaneous melanoma for the period 2007-2018 following the inclusion criteria of the International Agency for Research on Cancer (IARC). Clinical and histological characteristics of melanoma patients were assessed. A total of 1058 patients were included. The incidence rates obtained matched the latest available Canary Islands' cancer registry data, confirming its reliability (ASR, Segi-Doll world standard population: 6.4 cases per 100,000 habitants for 2008-2012). The incidence was also below the latest IARC predictions for Southern Europe (GLOBOCAN 2018). Histological characteristics of patients were similar to other Southern European series. The incidence of skin melanoma in Gran Canaria is unexpectedly low for a Southern European population exposed to such a high UVI. Further research in the Canary Islands could provide insight into a better understanding of melanoma pathogenesis.

Trends in the characteristics of skin melanoma in accordance with time intervals: A single Turkish tertiary referral center experience.

The incidence of skin melanoma has increased dramatically in recent years. The aim of this study was to analyze the trends in the features of Turkish cutaneous melanoma patients in a 25-year period. A total of 1258 adult melanoma patients who had been managed and followed up at a tertiary referral center between 1993 and 2017 were included in the study. Males were predominant which did not vary between time intervals. There was an increase in the percentage of older patients over the years, whereas no change was observed in the percentage of younger patients. As the percentage of lower extremity melanoma dropped, the percentage of truncal melanomas rose. Both the incidences of thick (T3-T4) and thin melanomas (T1) were found to increase over time by 13.4% and 3.8%, respectively. There was no significant change in the percentage of the metastatic disease; however, Stage III disease was found to multiply by 10.1% and local disease was found to fall by 8.5% over the period. The percentages of patients with nodular histopathology and tumor-infiltrating lymphocytes were found to plummet, and there was a slight decline in the percentages of patients with high mitotic rate and lymphovascular invasion. Most likely because of the delayed diagnosis, cutaneous melanoma was found to be associated with less favorable prognostic features as the time lapsed. We suggest that effective campaigns for public awareness of melanoma be implemented so the screening and early diagnosis of the disease can be promoted.

Association of Bariatric Surgery With Skin Cancer Incidence in Adults With Obesity

Obesity is a cancer risk factor, and bariatric surgery in patients with obesity is associated with reduced cancer risk. However, evidence of an association among obesity, bariatric surgery, and skin cancer, including melanoma, is limited. To investigate the association of bariatric surgery with skin cancer (squamous cell carcinoma and melanoma) and melanoma incidence. This nonrandomized controlled trial, the Swedish Obese Subjects (SOS) study, is ongoing at 25 surgical departments and 480 primary health care centers in Sweden and was designed to examine outcomes after bariatric surgery. The study included 2007 patients with obesity who underwent bariatric surgery and 2040 contemporaneously matched controls who received conventional obesity treatment. Patients were enrolled between September 1, 1987, and January 31, 2001. Data analysis was performed from June 29, 2018, to November 22, 2018. Patients in the surgery group underwent gastric bypass (n = 266), banding (n = 376), or vertical banded gastroplasty (n = 1365). The control group (n = 2040) received the customary treatment for obesity at their primary health care centers. The SOS study was cross-linked to the Swedish National Cancer Registry, the Cause of Death Registry, and the Registry of the Total Population for data on cancer incidence, death, and emigration. The study included 4047 participants (mean [SD] age, 47.9 [6.1] years; 2867 [70.8%] female). Information on cancer events was available for 4042 patients. The study found that bariatric surgery was associated with a markedly reduced risk of melanoma (adjusted subhazard ratio, 0.43; 95% CI, 0.21-0.87; P = .02; median follow-up, 18.1 years) and risk of skin cancer in general (adjusted subhazard ratio, 0.59; 95% CI, 0.35-0.99; P = .047). The skin cancer risk reduction was not associated with baseline body mass index or weight; insulin, glucose, lipid, and creatinine levels; diabetes; blood pressure; alcohol intake; or smoking. The results of this study suggest that bariatric surgery in individuals with obesity is associated with a reduced risk of skin cancer, including melanoma. ClinicalTrials.gov identifier: NCT01479452.

SKIN MELANOMA INCIDENCE IN WORKERS OCUPATIONALLY EXPOSED TO IONIZING RADIATION OVER A PROLONGED PERIOD

Purpose of the study. The study is aimed to investigate skin melanoma incidence in workers occupationally exposed to radiation over a prolonged period. Materials and methods. Skin melanoma incidence was studied in a cohort of workers first employed at nuclear facility Mayak Production Association (PA) between 1948 and 1982 who had been followed up till 31.12.2013 (22,377 individuals). Mean cumulative doses from external gamma-rays over the whole follow-up period were 0.54±0.001 Sv in males and 0.44±0.002 Sv in females. Incident rates for skin melanoma were analyzed by sex, attained age, calendar period of diagnostics and radiation dose using worldwide standard and the direct standardization technique. Results. 60 skin melanoma cases (37 in males and 23 in females) were registered in the study cohort over the whole follow-up period. The standardized skin melanoma incident rate was 8.51±1.46 in males and 8.78±2.27 in females per 100000 workers revealing statistically higher rates compared to corresponding rates for general populations of the Russian Federation, Urals Federal District and Chelyabinsk region. Skin melanoma incidence was significantly increased in the period of 1994 - 2013 as compared to the period of 1974 - 1993. Skin melanoma incidence excess in females was greater than that for males. Skin melanoma incidence increment in females was mostly driven by modifications of disease occurrence risk while in males it was driven by a combined effect of age pattern modifications in the study cohort and increase of disease risk. Conclusions. Skin melanoma incidence rates in the cohort of workers occupationally exposed to ionizing radiation over a prolonged period were associated with sex and attained age workers and the calendar period of diagnostics. No significant association of skin melanoma incidence with dose from external gamma-rays was observed. A significantly increasing trend was observed for skin melanoma incidence by the end of the follow-up in both males and females.

On the Connection between Planets, Dark Matter and Cancer: Comment on “Planetary Dependence of Melanoma”

In a recent paper, Zioutas and Valachovic (2018) claim that dark matter is responsible for a significant fraction of the melanoma skin cancer. This conclusion is drawn from their observation of a significant correlation between skin melanoma incidence in the US and the inner planets positions (especially those of Mercury and Earth). Here, I present a number of objections to their interpretation. Some (but not all) of the counterarguments are based on the analysis of a larger dataset from the same source, considering more cancer types and separating by patient attributes, such as race. One of the counterarguments is that if the melanoma fluctuations with periods similar to planetary orbits were produced by dark matter density enhancements on Earth, then we would have to conclude that the black population is somehow immune to dark matter, a conclusion that seems incompatible with the current Weakly-Interacting Massive Particles (WIMP) paradigm. Interestingly, some periodicities are present in the data, including the ones reported by Zioutas and Valachovic, but I argue that they must have a societal rather than astronomical origin.

What has changed in the epidemiology of skin melanoma in central Italy during the past 20 years?

The aim was to evaluate changes in skin melanoma incidence and mortality at a population level in central Italy over the past two decades. Skin melanoma incidence rate from 1994 to 2014, were retrieved from the Umbrian Cancer Registry (about 900 000 inhabitants). Changes from 1994-1999 to 2010-2014 in tumour and patient characteristics - sex, age (0-44, 45-64, ≥ 65 years), site (head and neck, trunk, limbs), morphology (superficial spreading, nodular, other), thickness (≤ 1, 1-2, 2-4, > 4) and stage I-II, III-IV - were evaluated. Trends in age-standardized incidence and mortality rates were evaluated as annual percent change. During the past two decades, melanoma incidence significantly increased in both sexes (+6%/year among men and +4%/year among women) and in all ages (0-44 years: + 4.7 and + 4.3; 45-64 years: + 6.1 and + 4.4; ≥65 years: + 6.6 and + 1.7), morphologies, except nodular, and stages. Mortality was stable among men and women. In the area, incidence increased for thin and thick melanoma, showing a true increase, whereas mortality did not increase. Therefore, although improvements in treatment and downstaging effect of early diagnosis have to be considered, a certain degree of overdiagnosis cannot be ruled out.