title: Temporal and spatial melanoma trends in Austria: an ecological study.
abstract: Annual solar ultraviolet radiation (UVR) is mostly determined by latitude and altitude. Over the last decades, increasing UVR ground levels have been observed. Exposure to UVR is associated with a life-time risk to develop melanoma, a malign skin cancer. Thus, we hypothesized that melanoma incidence in Austria is associated with altitude of place of living and time of diagnosis. We investigated this hypothesis in an ecological study by district and year for Austrian melanoma incidence (1990-2010) and mortality (1970-2011) data. As expected, incidence rates increased with altitude (about 2% per 10 m) and year (about 2%). Additionally, melanoma incidence rates were about 50% higher in urban than in rural districts. In contrast, mortality rates decreased with altitude (for males: 0.4% per 10 m, for women: 0.7% per 10 m, respectively). The observed discrepancy between incidence and mortality data could partly be explained by melanoma diagnosis at earlier tumor stage in districts with higher altitude. Possible reasons for this finding include higher awareness of patients, better diagnostic performance of medical professionals working at higher altitudes, or slower tumor growth due to protective effects of sun light-associated vitamin D synthesis.
authors.affiliation: Center for Public Health, Institute of Environmental Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria. daniela.haluza@meduniwien.ac.at.
authors.forename: Daniela
authors.initials: D
authors.lastname: Haluza
authors.affiliation: Center for Public Health, Institute of Environmental Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria. stana.simic@boku.ac.at.
authors.forename: Stana
authors.initials: S
authors.lastname: Simic
authors.affiliation: Center for Public Health, Institute of Environmental Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna A-1090, Austria. hanns.moshammer@meduniwien.ac.at.
authors.forename: Hanns
authors.initials: H
authors.lastname: Moshammer
mesh_terms: D000328:Adult; D000368:Aged; D000531:Altitude; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000401:mortality*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000401:mortality*; D055815:Young Adult