The control of melanoma in New Zealand.
OBJECTIVE
This study estimated the impact of prevention, screening, early diagnosis, and treatment on the burden of melanoma in New Zealand.


METHODS
Cancer control plans and management guidelines were reviewed to identify activities that could reduce the burden of melanoma in New Zealand and an estimation was made of their effects on incidence and mortality. The base year for estimating changes in incidence and mortality was the published melanoma data for 2002.


RESULTS
The registration of melanoma increased from 1037 new registrations in 1993 to 1487 in 1994 and peaked at 1759 in 1995. In 2002 a further increase occurred, to 1842 new registrations and 235 deaths from melanoma. It is likely that 328 of the 1842 new cases of melanoma in 2002 were directly attributable to severe sunburn. A reduction of 10% in the number of people getting severely sunburnt could prevent 28 melanoma cases per year. If 2% of melanoma deaths occur in high-risk individuals, approximately 4 deaths per year could be prevented by surveillance of high-risk groups. Thin melanoma has a very good prognosis: a 10% shift in the depth distribution into the thinnest depth category would result in about 29 deaths from melanoma prevented each year.


CONCLUSIONS
The best avenues for reducing the burden of melanoma in New Zealand are prevention of excessive sun exposure and early diagnosis. Reducing severe sunburn and diagnosing a greater proportion of melanomas when they are thin would have the greatest impact on the incidence of and mortality from melanoma.
Sneyd
Mary
M
Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin. mary-jane.sneyd@stonebow.otago.ac.nz
Cox
Brian
B
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D017281:Cost of Illness; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D008875:Middle Aged; D009026:Mortality; D009520:New Zealand / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D011322:Primary Prevention / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D013471:Sunburn / Q000453:epidemiology