Who dies from melanoma? A population-based study of Irish patients

Who dies from melanoma? A population-based study of Irish patients.

Background: Incidence of melanoma of the skin tends to be higher among patients from more affluent backgrounds, but survival from melanoma also tends to be higher in that group (and among women). Other demographic or geographic differences might also be expected.

Objectives: To assess disparities in cause-specific survival for melanoma patients diagnosed in Ireland during 1994-2008.

Methods: Descriptive statistics on incidence, stage and survival are presented, and survival variations are assessed by Cox modelling.

Results: Invasive melanoma incidence was c40% lower in the most deprived compared with the least deprived population stratum. In situ melanomas were less frequent proportionately in the most deprived compared to the least deprived group (29% v 32%), likewise stage I melanomas (42% v 47% of invasive cases). Five-year survival from invasive melanoma averaged 81% for the most deprived compared with 86% for the least deprived group overall (age-/sex-adjusted hazard ratio 1.33, 95% CI 1.11-1.58); in men, 71% v 79% (HR 1.47, CI 1.16-1.84); in women, 88% v 90% (HR 1.17, CI 0.89-1.52). Deprivation-related disparities in survival appeared to improve over the study period, and appeared less marked for women. Significant disparities remained for the most deprived group after adjustment for stage, overall (HR 1.22, CI 1.01-1.45) and in men (HR 1.35, 1.06-1.72).

Conclusions: Unexplained disparities seen in this analysis suggest the possible involvement of other prognostic, lifestyle or treatment-related factors, not all of which may be available in routine cancer registry data.