Trends in the survival of patients diagnosed with malignant melanoma of the skin in the Nordic countries 1964-2003 followed up to the end of 2006.
A previous Nordic study showed a marked and steady increase in the age-adjusted 5-year relative survival of skin melanoma patients diagnosed during the period 1958 through 1987. Males had considerably poorer survival than females.


METHODS
Using the NORDCAN database, we studied relative survival and excess mortality of patients diagnosed with melanoma of the skin in the Nordic countries 1964-2003 followed up to the end of 2006. These were contrasted with concomitant trends in incidence and mortality.


RESULTS
The overall incidence of melanoma almost quadrupled, but there was considerable variation in the trends in the five countries. Mortality was low but doubled during the study period. Survival ratios increased steadily to between 80% and 90% for patients diagnosed in 1999-2003. Swedish patients had consistently higher survival, whereas Danish patients had the highest excess death rates the first three months after diagnosis up until 1990, but thereafter, rates reached a similar low level to that observed in the other Nordic countries. The survival of Nordic women is still higher than that of men, but the difference has diminished, while the mortality rates among men are becoming increasingly higher relative to those for women among individuals 50 years and older. In younger individuals, mortality rates are similar in the two sexes, and declining.


CONCLUSIONS
Nordic patient survival following melanoma diagnosis is generally high and has been steadily increasing in the last decades. Differences in incidence between the five countries are more pronounced than the differences in survival. The strong upward trends in incidence and survival may mainly be the result of extensive changes in sunbathing habits or other UV exposure and, more recently, of an increasing awareness by the medical community and the public concerning early detection of melanoma of the skin.
Tryggvadóttir
Laufey
L
Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland. laufeyt@krabb.is
Gislum
Mette
M
Hakulinen
Timo
T
Klint
Asa
A
Engholm
Gerda
G
Storm
Hans H
HH
Bray
Freddie
F
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015986:Confounding Factors, Epidemiologic; D003718:Denmark / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008403:Mass Screening; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D055108:Sunbathing / Q000639:trends; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D014466:Ultraviolet Rays / Q000009:adverse effects