title: A study of melanoma in Eastern European migrants in Italy.
abstract: Cancer survival rates are lower in Eastern Europe. To describe, based on a single-centre database in northern Italy, clinical, histopathological, and prognostic features of melanoma in a migrant population from Eastern Europe.
  
  
  METHODS
  We retrospectively analysed data from 18,190 consecutive foreign patients who visited our institution, with 49 cases of melanoma from Eastern Europe. The control group was represented by 1,003 Italian melanoma patients diagnosed and followed at our centre during the same time period. Patients from Eastern Europe were mainly females with lower median age, without significant differences regarding primary melanoma site, relative to the control group. Diagnosis was made at the place of birth in 30.6% and in our centre for the remainder. Median Breslow thickness was greater (p = 0.0178), and aggressive histotypes (p = 0.0017) and ulcerated melanomas (p = 0.002) were significantly over-represented, particularly when diagnosed in the patients' native country. Disease was more advanced at diagnosis (p = 0.0001), regardless of the place of initial diagnosis (51% had a progressive disease within one year which rose to 80% if diagnosed before admission to our centre), and the percentage of patients who died within one year was significantly higher (p = 0.022), relative to the control group. Our study shows a poor prognosis for melanoma patients diagnosed in Eastern Europe. Moreover, for migrant populations moving from Eastern to Western European countries, financial difficulties, poor social integration, and language barriers, with consequent late access to healthcare facilities, may account for a worse prognosis.
authors.affiliation: Department of Medical Science, University of Turin, Turin, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Astrua
authors.affiliation: Department of Medical Science, University of Turin, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fava
authors.affiliation: Department of Medical Science, University of Turin, Turin, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Brizio
authors.affiliation: Department of Medical Science, University of Turin, Turin, Italy, Department of Health Sciences, "A. Avogadro" University of Eastern Piedmont, Novara, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Savoia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004641:Emigration and Immigration; D005061:Europe, Eastern / Q000208:ethnology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate; D055815:Young Adult
keywords: Eastern Europe; melanoma; migrant population; prognosis