title: Trends in prognostic factors and survival from cutaneous melanoma in Yorkshire, UK and New South Wales, Australia between 1993 and 2003.
abstract: The aim of this study was to compare trends in prognostic factors and survival from cutaneous melanoma between 1993 and 2003 in 2 populations with dramatically different underlying incidence rates [Yorkshire, UK, and New South Wales (NSW), Australia] and to look at whether the greater investment in melanoma prevention and early detection in Australia has resulted in any relative differences in survival. Patients diagnosed with invasive melanoma between 1993 and 2003 in Yorkshire (n = 4,170) and NSW (n = 30,520) were identified from cancer registry databases and prognostic information (age, sex, socioeconomic background, tumour site and Breslow thickness) was extracted. Age-standardised incidence rates, 5-year relative survival and relative excess risk of death were calculated. Between 1993-1995 and 2001-2003, the incidence of melanoma increased in both areas. These increases were mainly seen in tumours with thickness <or=1 mm. Five-year relative survival was 86.9% (95% CI 85.2-88.5) in Yorkshire and 88.6% (95% CI 88.1-89.1) in NSW. Compared with that in NSW, survival in Yorkshire was lower for males and for those living in the most deprived areas. Despite the increase in good prognosis of thin tumours, there was no significant change in survival over the time period in either area. After adjustment for differences in prognostic factors, the relative excess risk of death in Yorkshire compared to that in NSW reduced from 1.36 (95% CI 1.20-1.53) to 1.11 (95% CI 0.99-1.23). Differences in tumour thickness appeared to be the most important factor.
authors.affiliation: Cancer Epidemiology Group, Centre of Epidemiology and Biostatistics, University of Leeds, Leeds, LS2 9JT, United Kingdom. a.downing@leeds.ac.uk
authors.forename: Amy
authors.initials: A
authors.lastname: Downing
authors.forename: Xue Qin
authors.initials: XQ
authors.lastname: Yu
authors.forename: Julia
authors.initials: J
authors.lastname: Newton-Bishop
authors.forename: David
authors.initials: D
authors.lastname: Forman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011379:Prognosis; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology