학술논문
Increasing melanoma incidence and survival trend shifts with improved melanoma-specific survival between 1990 and 2020 in Sweden
Document Type
Author
Source
The British journal of dermatology. 189(6):702-709
Subject
Language
English
ISSN
1365-2133
Abstract
BACKGROUND: The melanoma-specific survival (MSS) is heterogenous between stages and is highly dependent on the T stage for primary localized disease. New systemic therapies for metastatic cutaneous melanoma (CM) have been introduced since 2012 in Sweden.OBJECTIVES: To analyse the incidence and MSS time trends between 1990 and 2020 in Sweden.METHODS: Nationwide, population-based, and prospectively collected clinico-pathological data on invasive CM from the Swedish Melanoma Registry (SweMR) were analysed for survival trends between 1990 and 2020 by using Kaplan-Meier curves and Cox Proportional Hazard ratios.RESULTS: In total, 77 036 primary invasive CM were diagnosed in 70 511 patients in Sweden between 1990 and 2020. The 5-year MSS was 88.9% (88.3-89.4) 1990-2000, 89.2% 2001-2010, and 93.0% (92.7-93.9) 2011-2020. The odds ratios for being diagnosed with nodular melanomas (vs. superficial spreading melanoma) was significantly reduced by 20% (2001-2010) and by 46% (2011-2020 vs. 1990-2000). Overall, the MSS improved over both diagnostic periods (2001-2010 and 2011-2020) vs the reference period 1990-2000 among men and women, respectively, (HRmen, 2001-2010: 0.89, 95% CI 0.82-0.96; HRmen, 2011-2020: 0.62, 95% CI 0.56-0.67. HRwomen, 2001-2010: 0.82, 95% CI 0.74-0.91; HRwomen, 2011-2020: 0.62, 95% CI 0.56-0.70). The risk of CM-death was significantly lower in all age groups for both men and women in the most recent diagnostic period (2011-2020 vs. 1990-2000).CONCLUSIONS: The results are emphasizing the improved MSS among both men and women in Sweden. The MSS improvements, specifically for the period 2011-2020, may be correlated to the introduction of new systemic therapies and are here shown for the first time in detail for Sweden.