Quality assurance in melanoma care: The EU-MELACARE study.

BACKGROUND: A significant disparity regarding survival outcome for melanoma among European regions is well recognized and access to high quality care for European melanoma patients needs to be improved. There is an unmet need for the implementation of minimal standard of care within defined clinical pathways and Quality Assurance (QA) indicators. OBJECTIVE: The EU-MELACARE study aims to identify shared variables for cutaneous melanoma cases recorded in melanoma registries across Europe. MATERIAL AND METHODS: Opinion leaders involved in melanoma data registration and care quality analysis in 34 European countries were invited to respond to an expert survey covering questions regarding the melanoma registration practice in their countries and the characteristics, coverage and variables collected by the relevant melanoma registries. RESULTS: Data regarding 13 melanoma registries from 11 European countries contributed to the study. The majority (61,5%) were population based registries and more than half (62%) had national coverage. The included registries collected a median of 38 variables (Interquartile Range, IRQ 21-76). We identified 24 shared variables available in >70% of registries. CONCLUSIONS: This study provides valuable specific information on information recorded for melanoma cases are registered within Europe. A core of shared variables has been identified, which will constitute the basis for a standardized set of QA indicators for assessing and monitoring melanoma care across European countries.

Assessment of Quality of Life of Women with Breast Cancer.

BACKGROUND: Breast cancer is the most common type of cancer among women in 145 countries worldwide, and the success of healthcare for women with this disease is measured with the quality of life of survivors. The aim of this study was to examine how the breast cancer affects the quality of life and in what dimension of health quality of life is the least accomplished. METHOD: A pilot research had been performed in the period from June 10 to August 15 2011, on 100 women from Association of women with breast cancer "Iskra" in Banja Luka, aged 20-75. The survey research was based on the EORTC QLQ-C30 version 3.0 and questionnaire for assessment of quality of life of those suffering from breast cancer QLQ-BR23 with 53 questions in total. RESULTS: The average age of women in research was 51.8 years (±11.23). Statistically important differences (χ24=221.941; p<0.01) are higher mean values of the score for the functional scale, (66.32±17.82) cognitive functions (63.50 ±28.00) in relation to functional role (46.83 ±20.88), social (37.00 ±27.58) and emotional (36.58 ±25.15) functioning. Mean values of the score for the symptoms scale were statistically higher for symptoms such as fatigue, insomnia and pain in relation to other symptoms. Mean values of the score for body image scale are statistically higher in relation to mean values of the score of sexual functions and enjoyment scale, and the scale for grading the future perspectives. CONCLUSION: Breast cancer affects all the domains of the quality of life, and in our population it is the most prominent in domains of emotional and social functions, as well as role functions. Symptoms of fatigue, insomnia and pain have the most importance influence on these domains.

Disparities in melanoma incidence and mortality in South-Eastern Europe: Increasing incidence and divergent mortality patterns. Is progress around the corner?

INTRODUCTION: Most countries in South-Eastern Europe (SEE) have lower incidence, but higher mortality rates of malignant melanoma (MM) of the skin compared to North-Western Europe (NWE). We explored trends in MM incidence and mortality in SEE countries by sex and age and compared them with the trends in NWE. METHODS: We obtained data on incident cases and deaths from MM (ICD-10 code C43) from 11 population-based cancer registries in Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Malta, Romania, Serbia, Slovakia, Slovenia and Turkey. We calculated age-specific rates for 25-49 ('young'), 50-69 ('middle aged') and 70+ years ('older') and estimated the average annual percent of change in incidence and mortality trends 2000-2010 according to age group and sex, using joinpoint regression analysis. FINDINGS: The incidence rates of MM across the region were uniformly increasing. Significant increases in mortality rates were observed in middle aged men in Serbia and Bulgaria, middle aged women in Slovenia, older men in the Czech Republic, Serbia and Turkey, and older women in Slovenia and Serbia. INTERPRETATION: While MM incidence rates were still increasing across SEE, mortality trends diverged and were less favourable than in NWE. Empowering cancer registration and improving the quality of incidence and mortality data will be essential for monitoring progress in MM control. In the context of prevention of melanoma, disparities in early detection appear to be widening the gap between SEE and NWE, while the provision of care to patients with advanced disease is likely to prove a challenge for regional healthcare budgets.