title: Socioeconomic patterning in the incidence and survival of children and young people diagnosed with malignant melanoma in northern England.
abstract: Previous studies have found marked increases in melanoma incidence. The increase among young people in northern England was especially apparent among females. However, overall 5-year survival has greatly improved. The present study aimed to determine whether socioeconomic factors may be involved in both etiology and survival. All 224 cases of malignant melanoma diagnosed in patients aged 10-24 years during 1968-2003 were extracted from a specialist population-based regional registry. Negative binomial regression was used to examine the relationship between incidence and area-based measures of socioeconomic deprivation and small-area population density. Cox regression was used to analyze the relationship between survival and deprivation and population density. There was significantly decreased risk associated with living in areas of higher unemployment (relative risk per 1% increase in unemployment=0.93; 95% confidence interval (CI) 0.90-0.96, P<0.001). Survival was better in less deprived areas (hazard ratio (HR) per tertile of household overcrowding=1.52; 95% CI 1.05-2.20; P=0.026), but this effect was reduced in the period 1986-2003 (HR=0.61; 95% CI 0.40-0.92; P=0.018). This study found that increased risk of melanoma was linked with some aspects of greater affluence. In contrast, worse survival was associated with living in a more deprived area.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. Electronic address: Richard.McNally@ncl.ac.uk.
authors.forename: Richard J Q
authors.initials: RJQ
authors.lastname: McNally
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Nermine O
authors.initials: NO
authors.lastname: Basta
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Errington
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Peter W
authors.initials: PW
authors.lastname: James
authors.affiliation: School of Geography, University of Leeds, Leeds, UK.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Norman
authors.affiliation: Northern Institute of Cancer Research, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Alan W
authors.initials: AW
authors.lastname: Craft
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000191:economics* / Q000453:epidemiology / Q000401:mortality*; D016016:Proportional Hazards Models; D012042:Registries; D012306:Risk; D012878:Skin Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000401:mortality*; D012923:Social Class; D016896:Treatment Outcome; D055815:Young Adult