Trends in incidence and predictions of cutaneous melanoma across Europe up to 2015.

BACKGROUND: Melanoma is a significant health problem in Caucasian populations. The most recently available data from cancer registries often have a delay of several months up to a few years and they are generally not easily accessible. OBJECTIVES: To assess recent age- and sex-specific trends in melanoma incidence and make predictions for 2010 and 2015. METHODS: A retrospective registry-based analysis was performed with data from 29 European cancer registries. Most of them had data available from 1990 up to 2006/7. World-standardized incidence rates (WSR) and the estimated annual percentage change (EAPC) were computed. Predictions were based on linear projection models. RESULTS: Overall the incidence of melanoma is rapidly rising and will continue to do so. The incidence among women in Europe was generally higher than in men. The highest incidence rates were seen for Northern and north-western countries like the UK, Ireland and the Netherlands. The lowest incidence rates were observed in Portugal and Spain. The incidence overall remained stable in Norway, where, amongst young (25-49 years) Norwegian males rates significantly decreased (EAPC -2.8, 95% CI -3.6; -2.0). Despite a low melanoma incidence among persons above the age of 70, this age group experienced the greatest increase in risk during the study period. CONCLUSIONS: Incidence rates of melanoma are expected to continue rising. These trends are worrying in terms of disease burden, particularly in eastern European countries.

Incidence, pathology and outcome of gynaecological cancer in patients under the age of 21 years in South-west England 1995-2004: comparison of data from regional, national and international registries.

We analysed the incidence, tumour types, management and outcome of gynaecological cancer diagnosed from 1995-2004 in females <21 years in south-west England. Data from the South West Cancer Intelligence Service were compared with those from regional and national registries. A total of 63 patients had gynaecological malignancies: 49 ovarian; nine cervical; the remainder vaginal, uterine or pelvic. The median age was 16 years. Germ cell tumours (26) and carcinomas (6) were the commonest primary ovarian and cervical tumours respectively. Most patients had fertility-sparing procedures. Only seven required re-operation. Information about chemoradiotherapy was incomplete. Four deaths occurred. All patients were followed >3 years and 68% >5 years, with 94% survival to date. Fertility preservation did not impair survival. Mortality is an inadequate indicator of outcome; cancer registries should record information on fertility and pregnancy outcomes, second tumours and long-term treatment-related complications. Improved management requires greater centralised assessment of histology, follow-up and adjuvant treatment.