A ten-year analysis of demographic trends for cutaneous melanoma: analysis of 2501 cases treated at the University Department of Dermatology in Vienna (1990-1999).
BACKGROUND
The aim of the study is to provide recent demographic data on cutaneous melanoma in Austria.


METHODS
Patients with primary cutaneous melanoma diagnosed between January 1, 1990 and December 31, 1999 were included in the analysis. Data were retrieved from the melanoma registry of the University Department of Dermatology in Vienna.


RESULTS
In the observation period, 2501 cutaneous melanomas were diagnosed in 2427 patients (mean age: 55.4 yrs; 51.2% females). A total of 267 (10.7%) cutaneous melanomas were in situ, and 2234 (89.3%) were invasive. The median invasion thickness according to Breslow for invasive melanomas was 0.98 mm (25%-75% percentiles: 0.55-2.00 mm). We observed a significant trend towards thicker tumors with increasing age (p < 0.001). In patients less than fifty years of age, a significantly higher Breslow thickness was observed in men than in women (0.90 mm versus 0.80 mm, p = 0.03). The median Breslow thickness of invasive melanoma decreased from 1.20 mm in 1990 to 0.92 mm in 1999 (p for trend, < 0.001). Compared to women, men had melanomas more frequently on the back (43.8% versus 24.4%, p < 0.001). In women, melanomas were more frequently found on the lower legs than in males (21.5% versus 6.7%, p < 0.001). In a multivariate model, invasion thickness according to Breslow was the single most important predictor of survival.


CONCLUSIONS
Our data confirm recent reports from other European countries with regard to the decline in tumor thickness of cutaneous melanoma. Our data also demonstrate a need for improving early diagnosis, particularly in certain subgroups of patients.
Kittler
H
H
Department of Dermatology, Division of General Dermatology, University of Vienna Medical School, Vienna, Austria. h.kittler@akh-wien.ac.at
Binder
M
M
Wolff
K
K
Pehamberger
H
H
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016017:Odds Ratio; D011159:Population Surveillance; D016016:Proportional Hazards Models; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000503:physiopathology; D016019:Survival Analysis