Melanoma Incidence and Mortality in Europe

New Estimates, Persistent Disparities

A.M. Forsea; V. del Marmol; E. de Vries; E.E. Bailey; A.C. Geller

Disclosures

The British Journal of Dermatology. 2012;167(5):1124-1130. 

In This Article

Summary and Introduction

Summary

Background Melanoma incidence and mortality in Europe are high but there are significant gaps in the epidemiological information available across the continent.
Objectives With the aim of enhancing the planning of educational programmes for reducing the melanoma burden in Europe, we analysed the most recent incidence and mortality data for Europe with a new focus on the regional disparities of melanoma reporting.
Methods GLOBOCAN 2008, the standard set of worldwide estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer for 2008, was used to provide the estimated age-standardized rates (world standard population) of melanoma incidence and mortality in European countries and regions.
Results The estimated age-standardized incidence of melanoma (measured per 100 000 person-years) varies widely from 19·2 in Switzerland to 2·2 in Greece. The incidence rate of 4·3 of Central and Eastern Europe (CEE) is less than half of that of Western Europe. Melanoma mortality rates of 1·5 are similar in CEE and Western Europe, although rates vary with a high of 3·2 in Norway and a low of 0·9 in Greece. Over 20 000 deaths from melanoma were estimated in Europe in 2008, with CEE having the largest share (35·5%) among the four geographical European regions. Population-based data are lacking for significant parts of CEE, which must rely on estimates.
Conclusions The most recent estimates of melanoma incidence and mortality in Europe reveal sharp differences between European countries, possibly related to missed opportunities for early diagnosis and incomplete reporting of melanoma in Eastern Europe.

Introduction

Numerous studies[1–8] have documented increases of melanoma incidence throughout Europe in the last few decades. Recent reports have indicated plateaus and decreases of incidence rates among young age groups in several Western European and Nordic countries, along with a marked shift towards earlier recognition of melanoma throughout Western Europe. At the same time, these reports drew attention to important discrepancies of melanoma incidence, mortality and survival across the continent, with countries from Central and Eastern Europe (CEE) reporting higher rates of advanced tumours and lower survival.[4,6,9] Complete nationwide surveillance and reporting of melanoma in CEE is scarce, relying mostly on accrual at the local or regional level.[10] Eastern European countries have been poorly represented in European consortia studies on cancer[4,6,9,11] and few countries in this region have quality cancer registration.[12]

Comprehensive surveillance data on cancer for Europe have become available through the effort of international agencies, such as the International Agency for Research on Cancer (IARC). IARC provides recorded, cancer registry-based[12] and estimated[13] European data on incidence and mortality rates for the major types of cancers, including melanoma. Recently, the latest estimates, updated to 2008, have been published,[13] and for some CEE countries, which lack functional cancer registration, these are the only public data available for melanoma.

These databases are a vital component for strategic planning for melanoma control in Europe. Herein, we provide an overview of the IARC's findings describing the estimated burden of melanoma in Europe. Particular attention is given to the situation of CEE while discussing the challenges of reporting, interpreting and using these data within a highly heterogeneous continent.

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