Babak Monshi1, Marin Vujic1, Danijel Kivaranovic2, Alma Sesti1, Willi Oberaigner3, Igor Vujic4, Susana Ortiz-Urda5, Christian Posch6, Hans Feichtinger7, Monika Hackl8, Klemens Rappersberger9. 1. Department of Dermatology and Venereology, The Rudolfstiftung Hospital, Teaching Hospital of Vienna Medical University, Juchgasse 25, A-1030 Vienna, Austria. 2. Centre for Medical Statistics, Informatics and Intelligent Systems (CeMSIIS), Medical University, Spitalgasse 23, A-1090 Vienna, Austria. 3. Institute for Clinical Epidemiology, Anichstraße 35, A-6020 Innsbruck, Austria. 4. Department of Dermatology and Venereology, The Rudolfstiftung Hospital, Teaching Hospital of Vienna Medical University, Juchgasse 25, A-1030 Vienna, Austria; University of California San Francisco, Mt. Zion Cancer Research Center, 2340 Sutter Street N461, San Francisco, CA, USA. 5. University of California San Francisco, Mt. Zion Cancer Research Center, 2340 Sutter Street N461, San Francisco, CA, USA. 6. Department of Dermatology and Venereology, The Rudolfstiftung Hospital, Teaching Hospital of Vienna Medical University, Juchgasse 25, A-1030 Vienna, Austria; Brigham and Women's Hospital, Harvard Medical School, 77 Avenue Louis Pasteur #660, 02115 Boston, MA, USA. 7. Department of Pathology and Microbiology, The Rudolfstiftung Hospital, Teaching Hospital of Vienna Medical University, Juchgasse 25, A-1030 Vienna, Austria. 8. Austrian National Cancer Registry, Directorate Social Statistics, Statistics Austria, Guglgasse 13, A-1110 Vienna, Austria. 9. Department of Dermatology and Venereology, The Rudolfstiftung Hospital, Teaching Hospital of Vienna Medical University, Juchgasse 25, A-1030 Vienna, Austria. Electronic address: klemens.rappersberger@wienkav.at.
Abstract
AIM OF STUDY: Incidence rates of melanoma, generated by cancer registries (CRs), are susceptible to reporting inconsistencies due to increasing decentralisation of diagnosis. We therefore independently assessed the burden of melanoma in Austria. METHODS: We collected histopathological reports on melanoma of all patients diagnosed in Austria in 2011. Demographic and clinical characteristics, histopathological tumour stages were assessed. Their regional distributions and incidence rates were analysed and compared with data of national and international CRs. RESULTS: A total of 5246 patients were diagnosed with 1951 in-situ and 3295 invasive melanomas in Austria in 2011 (population 8.4 million). Age, sex and anatomic distribution corresponded to findings in other European countries, however, the incidence of 25/100,000 (world age-standardised rate) for invasive melanomas was two-fold higher than published by the Austrian CR (12/100,000). Varying frequencies in diagnosing thin melanomas (≤1 mm; n = 4415) accounted exclusively for significant regional disparities, while advanced tumours (>1 mm; n = 761) were evenly distributed. Western Austria showed the highest rates (36/100,000). Patients from eastern Austria whose melanomas were diagnosed in laboratories in western Austria (n = 76) showed significantly higher proportions of in-situ lesions (n = 43; 57%) compared to those whose tumours were diagnosed in eastern Austria (n = 4014; in-situ = 1369; 34%) (p < 0.0001). CONCLUSIONS: In Austria, the melanoma burden and its potential socio-economic implications are significantly underestimated. Similarities of incidences indicate this could affect other European countries with well-established CRs and compromise international comparability of data. Austrian regional disparities suggest overdiagnosis of thin melanomas due to the variability of pathologists' thresholds for the diagnosis of early stage tumours.
AIM OF STUDY: Incidence rates of melanoma, generated by cancer registries (CRs), are susceptible to reporting inconsistencies due to increasing decentralisation of diagnosis. We therefore independently assessed the burden of melanoma in Austria. METHODS: We collected histopathological reports on melanoma of all patients diagnosed in Austria in 2011. Demographic and clinical characteristics, histopathological tumour stages were assessed. Their regional distributions and incidence rates were analysed and compared with data of national and international CRs. RESULTS: A total of 5246 patients were diagnosed with 1951 in-situ and 3295 invasive melanomas in Austria in 2011 (population 8.4 million). Age, sex and anatomic distribution corresponded to findings in other European countries, however, the incidence of 25/100,000 (world age-standardised rate) for invasive melanomas was two-fold higher than published by the Austrian CR (12/100,000). Varying frequencies in diagnosing thin melanomas (≤1 mm; n = 4415) accounted exclusively for significant regional disparities, while advanced tumours (>1 mm; n = 761) were evenly distributed. Western Austria showed the highest rates (36/100,000). Patients from eastern Austria whose melanomas were diagnosed in laboratories in western Austria (n = 76) showed significantly higher proportions of in-situ lesions (n = 43; 57%) compared to those whose tumours were diagnosed in eastern Austria (n = 4014; in-situ = 1369; 34%) (p < 0.0001). CONCLUSIONS: In Austria, the melanoma burden and its potential socio-economic implications are significantly underestimated. Similarities of incidences indicate this could affect other European countries with well-established CRs and compromise international comparability of data. Austrian regional disparities suggest overdiagnosis of thin melanomas due to the variability of pathologists' thresholds for the diagnosis of early stage tumours.
Authors: Valentin Feichtenschlager; Felix Weihsengruber; Leo Richter; Igor Vujic; Klemens Rappersberger; Christian Posch Journal: Wien Med Wochenschr Date: 2019-01-16
Authors: Shirin Bajaj; Douglas Donnelly; Melissa Call; Paul Johannet; Una Moran; David Polsky; Richard Shapiro; Russell Berman; Anna Pavlick; Jeffrey Weber; Judy Zhong; Iman Osman Journal: J Natl Cancer Inst Date: 2020-09-01 Impact factor: 13.506