title: Clinical and sociodemographic characteristics associated with thick melanomas. A population-based, case-case study in France.
abstract: OBJECTIVE
  To identify clinical and sociodemographic factors associated with very thick melanoma (VTM) (Breslow thickness, 3 mm) in France.
  
  
  METHODS
  Retrospective, population-based, case-case study using a survey of cancer registries and questionnaires to practitioners.
  
  
  METHODS
  Five regions covering 19.2% of the French territory and 8.2 million inhabitants.
  
  
  METHODS
  Cases included all incident melanomas with a Breslow thickness of 3 mm or greater (ie, VTM), diagnosed between January 1 and December 31, 2008, in residents of the study area (Alsace, Bourgogne, Champagne-Ardenne, Franche-Comte', and Lorraine, France), and a randomly selected sample of melanomas thinner than 3 mm.
  
  
  METHODS
  Circumstances of diagnosis,clinical and pathological characteristics of melanomas,and sociodemographic characteristics of patients(age, sex, residence, home and family life conditions, educational level, and smoking habits).
  
  
  RESULTS
  Among 898 melanomas, 149 (16.6%) were VTMs. Very thick melanomas were more often diagnosed in a general-practice setting than thinner melanomas.The rate of immediate clinical recognition by dermatologists was lower for VTMs than for thinner melanomas. In a multivariate logistic regression analysis,factors associated with VTM were the nodular and acrolentiginous types; the head and neck and lower limb locations; older age; male sex; and being single, separated,divorced, or widowed. When only factors related to patients were taken into account, older age, male sex,and living alone were independent risk factors for VTM.The most significant risk was observed for patients living alone.
  
  
  CONCLUSIONS
  Intrinsic factors related to the tumor and socio demographic characteristics of patients contribute to the occurrence of VTM. These factors should be better targeted in future secondary prevention programs.
authors.affiliation: Service de Dermatologie, Hôpital Robert Debré, Reims, Avenue du Général Koenig, 51092 Reims CEDEX, France. fgrange @chu-reims.fr
authors.forename: Florent
authors.initials: F
authors.lastname: Grange
authors.forename: Coralie
authors.initials: C
authors.lastname: Barbe
authors.forename: Francois
authors.initials: F
authors.lastname: Aubin
authors.forename: Dan
authors.initials: D
authors.lastname: Lipsker
authors.forename: Florence
authors.initials: F
authors.lastname: Granel-Brocard
authors.forename: Michel
authors.initials: M
authors.lastname: Velten
authors.forename: Sophie
authors.initials: S
authors.lastname: Dalac
authors.forename: François
authors.initials: F
authors.lastname: Truchetet
authors.forename: Catherine
authors.initials: C
authors.lastname: Michel
authors.forename: Audrey
authors.initials: A
authors.lastname: Mitschler
authors.forename: Gwendoline
authors.initials: G
authors.lastname: Arnoult
authors.forename: Antoine
authors.initials: A
authors.lastname: Buemi
authors.forename: Stéphane
authors.initials: S
authors.lastname: Dalle
authors.forename: Philippe
authors.initials: P
authors.lastname: Bernard
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Woronoff
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology*; D012959:Socioeconomic Factors