title: Survival of patients with skin melanoma in Europe increases further: Results of the EUROCARE-5 study.
abstract: BACKGROUND
  In Europe skin melanoma (SM) survival has increased over time. The aims were to evaluate recent trends and differences between countries and regions of Europe.
  
  
  METHODS
  Relative survival (RS) estimates and geographical comparisons were based on 241,485 patients aged 15years and over with a diagnosis of invasive SM in Europe (2000-2007). Survival time trends during 1999-2007 were estimated using the period approach, for 213,101 patients. Age, gender, sub-sites and morphology subgroups were considered.
  
  
  RESULTS
  In European patients, estimated 5-year RS was 83% (95% confidence interval, CI 83-84%). The highest values were found for patients resident in Northern (88%; 87-88%) and Central (88%; 87-88%) Europe, followed by Ireland and United Kingdom (UK) (86%; 85-86%) and Southern Europe (83%; 82-83%). The lowest survival was in Eastern Europe (74%; 74-75%). Within regions the intercountry absolute difference in percentage points of RS varied from 4% (North) to 34% (East). RS decreased markedly with patients' age and was higher in women than men. Differences according to SM morphology and skin sub-sites also emerged. Survival has slightly increased from 1999 to 2007, with a small improvement in Northern and the most pronounced improvement in Eastern Europe.
  
  
  CONCLUSIONS
  SM survival is high and still increasing in European patients. The gap between Northern and Southern and especially Eastern European countries, although still present, diminished over time. Differences in stage distribution at diagnosis may explain most of the geographical differences. However, part of the improvement in survival may be attributed to overdiagnosis from early diagnosis practices.
authors.affiliation: UO Epidemiologia Clinica, Descrittiva e Registri - ISPO, Firenze, Italy. Electronic address: emanuelecrocetti@yahoo.com.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Crocetti
authors.affiliation: Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Mallone
authors.affiliation: Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway.
authors.forename: Trude Eid
authors.initials: TE
authors.lastname: Robsahm
authors.affiliation: Northern Ireland Cancer Registry, Centre for Public Health, Queens University, Belfast, Northern Ireland, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Gavin
authors.affiliation: Malta National Cancer Registry, Department of Health Information and Research, Pieta, Malta.
authors.forename: Domenic
authors.initials: D
authors.lastname: Agius
authors.affiliation: Navarra Cancer Registry, Navarra Public Health Institute, Pamplona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.affiliation: Servicio de Epidemiología, Department of Epidemiology, Consejería de Sanidad, Murcia Health Authority, Murcia, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Maria-Dolores Chirlaque
authors.initials: MC
authors.lastname: Lopez
authors.affiliation: Department of Epidemiology and Biostatistics National, Institute for Health Development, Tallinn, Estonia.
authors.forename: Kaire
authors.initials: K
authors.lastname: Innos
authors.affiliation: Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Minicozzi
authors.affiliation: SC Chirurgia Plastica e Ricostruttiva, Ospedale S.M. Annunziata - Azienda Sanitaria di Firenze Centro di Riferimento Regionale per il Melanoma, Istituto Toscano Tumori, Firenze, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Borgognoni
authors.affiliation: Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pierannunzio
authors.affiliation: Institute of Cancer Epidemiology, University of Luebeck, Luebeck, Germany.
authors.forename: Nora
authors.initials: N
authors.lastname: Eisemann
keywords: Cancer survival; EUROCARE; European populations; Registries; Skin melanoma