Abstract
Background
Cancer survival rates are lower in Eastern Europe.
Objectives
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.
Materials & 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.
Results
Patients from Eastern Europe were mainly females with lower median age, without significant differences regarding primary melanoma site, relative to the control group. Diagnosiswas 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.
Conclusion
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.
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References
Spallek J, Razum O. Health of migrants: deficiencies in the field of prevention. Med Klin (Munich) 2007; 102: 451–6.
Arnold M, Razum O, Coebergh JW. Cancer risk diversity in nonwestern migrants to Europe: an overview of the literature. Eur J Cancer 2010; 46: 2647–59.
Jansen L, Gondos A, Eberle A, et al. Cancer survival in Eastern andWestern Germany after the fall of the iron curtain. Eur J Epidemiol 2012; 27: 689–93.
Kutikhin AG, Yuzhalin AE, Brailovskiy VV, et al. Analysis of cancer incidence and mortality in the industrial region of South-East Siberia from 1991 through 2010. Asian Pacific J Cancer Prev 2012; 13: 5189–93.
Stang A, Stabenowb R, Eisingerb B, Jockela KH. Site-and genderspecific time trend analyses of the incidence of skin melanomas in the former German Democratic Republic (GDR) including 19351 cases. Eur J Cancer 2003; 39: 1610–8.
Kandolf-Sekulovic L, Zivkovicĭ-Perisic S, Radevicĭ T, et al. Melanoma in South-East Europe: epidemiological data from the central cancer registry and clinicopathological characteristics from the hospital-based registry in Serbia. Int J Dermatol 2012; 51: 1186–94.
Barbarić J, Znaor A. Incidence and mortality trends of melanoma in Croatia. Croat Med J 2012; 53: 135–40.
Azarjana K, Ozola A, Ruklisa D, et al. Melanoma epidemiology, prognosis and trends in Latvia. J Eu Acad Dermatol Venereol 2013; 27: 1352–9.
de Vries E, Bray FI, Eggermont AM, Coebergh JW. Monitoring stage-specific trends in melanoma incidence across Europe reveals the need for more complete information on diagnostic characteristics. Eur J Cancer Prev 2004; 13: 387–95.
Garbe C, Leiter U. Melanoma epidemiology and trends. Clin Dermatol 2009; 27: 3–9.
Baumert J, Schmidt M, Giehl KA, et al. Time trends in tumour thickness vary in subgroups: analysis of 6475 patients by age, tumour site and melanoma subtype. Melanoma Res 2009; 19: 24–30.
Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R. EUROCARE-4. Survival of cancer patients diagnosed in 1995-1999. Results and commentary. Eur J Cancer 2009; 45: 931–91.
de Vries E, Coebergh JW. Cutaneous malignant melanoma in Europe. Eur J Cancer 2004; 40: 2355–66.
Forsea AM, del Marmol V, de Vries E, Bailey EE, Geller AC. Melanoma incidence and mortality in Europe: new estimates, persistent disparities. Br J Dermatol 2012; 167: 1124–30.
Arnold M, Holterhues C, Hollestein LM, et al. Trends in incidence and predictions of cutaneous melanoma across Europe up to 2015. J Eur Acad Dermatol Venereol 2014; 28: 1170–8.
Stang A, Stang K, Stegmaier C, Hakulinen T, Joeckel KH. Skin melanoma in Saarland: incidence, survival and mortality 1970-96. Eur J Cancer Prev 2001; 10: 407–15.
Stang A, Lampert T, Uhlemann T, Trocchi P. Skin cancer mortality in Germany before and after the post-communist transition. Int J Dermatol 2009; 48: 363–70.
Troyanova P, Valerianova Z, Danon S. Clinical stages of cutaneous malignant melanoma in Bulgaria. Neoplasma 2000; 47: 257–60.
Stang A, Valiukeviciene S, Aleknaviciene B, Kurtinaitis J. Time trends of incidence, mortality, and relative survival of invasive skin melanoma in Lithuania. Eur J Cancer 2006; 42: 660–7.
Materljan E, Zamolo G, Petkovic M, et al. Malignant skin melanoma in Croatia. Coll Antropol 2009; 33: 1363–8.
Subramanian S. Communication at the Regional Melanoma Network Meeting Global Melanoma Task Force. Prague, Czech Republic, 2010.
Marugame T, Zhang MJ. Comparison of time trends in melanoma of skin cancer mortality (1990-2006) between countries based on the WHO mortality database. Jpn J Clin Oncol 2010; 40:710.
Anikeeva O, Bi P, Hiller JE, Ryan P, Roder D, Han GS. Trends in cancer mortality rates among migrants in Australia: 1981-2007. Canc Epidemiol 2012; 36: e74-82.
Rutherford MJ, Ironmonger L, Ormiston-Smith N, et al. Estimating the potential survival gains by eliminating socioeconomic and sex inequalities in stage at diagnosis of melanoma. Br J Cancer 2015; 112: S116–23.
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Astrua, C., Fava, P., Brizio, M. et al. A study of melanoma in Eastern European migrants in Italy. Eur J Dermatol 27, 139–143 (2017). https://doi.org/10.1684/ejd.2016.2950
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DOI: https://doi.org/10.1684/ejd.2016.2950