title: Epidemiology of extracutaneous melanoma in the Netherlands.
abstract: BACKGROUND
  Reliable population-based incidence and survival data on extracutaneous melanoma (ECM) are sparse.
  
  
  METHODS
  Incidence data (1989-2006) from the Netherlands Cancer Registry were combined with vital status on January 1, 2008. Age-adjusted annual incidence rates were calculated by direct standardization, and the estimated annual percentage change was estimated to detect changing trends in incidence. Additionally, we carried out cohort-based relative survival analysis.
  
  
  RESULTS
  Ocular melanomas were the most common ECM subsite with European standardized incidence rates (ESR) of 10.7 and 8.2 per 1,000,000 person-years for males and females, respectively. In comparison, for cutaneous melanoma (CM), the ESRs for men and women were 122 and 155 per million person-years, respectively. No statistically significant trends in the incidence of ECM were detected, whereas an annual increase of 4.4% for men and 3.6% for women was detected in the incidence of CM. Relative survival for ECM was poor, but differed largely between anatomic subtypes ranging from a 5-year relative survival of 74% for ocular melanomas to 15% for certain subsites of mucosal melanomas.
  
  
  CONCLUSIONS
  Of all ECM subsites, ocular melanomas had the highest incidence and the best survival. Mucosal melanomas were the second most frequent subsite of ECM. Five-year relative survival for all ECM subtypes was worse if compared with CM. No statistically significant trends in the incidence of (subsites of) ECM were determined.
  
  
  CONCLUSIONS
  This study gives insight into the relative sizes of the different subgroups of ECM as well as an estimate of 5-year survival, which varies substantially by subsite.
authors.affiliation: Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Els R
authors.initials: ER
authors.lastname: Koomen
authors.forename: Esther
authors.initials: E
authors.lastname: de Vries
authors.forename: Leon C
authors.initials: LC
authors.lastname: van Kempen
authors.forename: Alexander C J
authors.initials: AC
authors.lastname: van Akkooi
authors.forename: Henk Jan
authors.initials: HJ
authors.lastname: Guchelaar
authors.forename: Marieke W J
authors.initials: MW
authors.lastname: Louwman
authors.forename: Tamar
authors.initials: T
authors.lastname: Nijsten
authors.forename: Jan-Willem W
authors.initials: JW
authors.lastname: Coebergh
mesh_terms: D000328:Adult; D000368:Aged; D016543:Central Nervous System Neoplasms / Q000453:epidemiology; D005134:Eye Neoplasms / Q000453:epidemiology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012878:Skin Neoplasms / Q000453:epidemiology; D016019:Survival Analysis