Dataset Information

Melanoma Thickness and Survival Trends in the United States, 1989 to 2009.

ABSTRACT:

Background

With melanoma incidence rising and mortality stable, some question whether the melanoma epidemic is real. Melanoma thickness and survival trends may provide insights, but previous studies have been limited because of missing data on thickness.

Methods

With a validated imputation method for missing thickness data, we characterized melanoma thickness and survival trends among men and women in the Surveillance, Epidemiology, and End Results (SEER)-9 registries between 1989 and 2009. A total of 98,498 cases of invasive melanoma were identified. All statistical tests were two-sided.

Results

Incidence per 100 000 person-years increased (13.94, 95% confidence interval [CI] = 13.65 to 14.23, to 21.87, 95% CI = 21.56 to 22.19, P < .001) between 1989 to 1991 and 2007 to 2009, fatal incidence remained stable (2.32, 95% CI = 2.2 to 2.4, to 2.08, 95% CI = 2.0 to 2.2, P = .20) between 1989 to 1991 and 1998 to 2000, and five-year survival increased (88.29%, 95% CI = 87.60% to 88.95%, to 91.68%, 95% CI = 91.22% to 92.12%, P < .001) between 1989 to 1991 and 2001 to 2003. Increase in incidence occurred across all thickness groups. Median thickness decreased (0.73 to 0.58mm). Geometric mean thickness decreased (0.77 to 0.65mm) 4.6% (95% CI = 4.2% to 5.0%) every three years in multivariable analysis. Thickness decreased among T1/T2 tumors (0.01-1.00 and 1.01-2.00mm) and among all age and sex groups, whites, non-Hispanics, and all body sites. However, thickness increased among T3/T4 tumors (2.01-4.00 and > 4.00mm) and nodular melanomas; acral lentiginous melanomas approached statistical significance. Thickness remained unchanged among some racial minorities. Melanoma-specific survival improved (hazard ratio [HR] = 0.89, 95% CI = 0.88 to 0.91) every three years in multivariable analysis. Improvements in survival occurred across all subgroups except nonblack minorities, and nodular and acral lentiginous subtypes.

Conclusions

Increasing incidence across all thickness groups coupled with T3/T4 lesions becoming thicker suggests that the melanoma epidemic is real and not simply an artifact of increased detection pressure of earlier-stage T1/T2 lesions. Survival is generally improving independent of thickness, but improvements in survival have not been experienced by certain minorities, and nodular and acral lentiginous subtypes.

SUBMITTER: Shaikh WR

PROVIDER: S-EPMC4857148 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

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Publications

Melanoma Thickness and Survival Trends in the United States, 1989 to 2009.

Shaikh Waqas R WR Dusza Stephen W SW Weinstock Martin A MA Oliveria Susan A SA Geller Alan C AC Halpern Allan C AC

Journal of the National Cancer Institute 20151112 1

<h4>Background</h4>With melanoma incidence rising and mortality stable, some question whether the melanoma epidemic is real. Melanoma thickness and survival trends may provide insights, but previous studies have been limited because of missing data on thickness.<h4>Methods</h4>With a validated imputation method for missing thickness data, we characterized melanoma thickness and survival trends among men and women in the Surveillance, Epidemiology, and End Results (SEER)-9 registries between 1989 ...[more]

PMID: 26563354

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Project description:Importance and objectivePrior influenza infection is a risk factor for invasive meningococcal disease. Quantifying the fraction of meningococcal disease attributable to influenza could improve understanding of viral-bacterial interaction and indicate additional health benefits to influenza immunization.Design, setting and participantsA time series analysis of the association of influenza and meningococcal disease using hospitalizations in 9 states from 1989-2009 included in the State Inpatient Databases from the Agency for Healthcare Research and Quality and the proportion of positive influenza tests by subtype reported to the Centers for Disease Control. The model accounts for the autocorrelation of meningococcal disease and influenza between weeks, temporal trends, co-circulating respiratory syncytial virus, and seasonality. The influenza-subtype-attributable fraction was estimated using the model coefficients. We analyzed the synchrony of seasonal peaks in hospitalizations for influenza, respiratory syncytial virus, and meningococcal disease.Results and conclusionsIn 19 of 20 seasons, influenza peaked?2 weeks before meningococcal disease, and peaks were highly correlated in time (??=?0.95; P <.001). H3N2 and H1N1 peaks were highly synchronized with meningococcal disease while pandemic H1N1, B, and respiratory syncytial virus were not. Over 20 years, 12.8% (95% CI, 9.1-15.0) of meningococcal disease can be attributable to influenza in the preceding weeks with H3N2 accounting for 5.2% (95% CI, 3.0-6.5), H1N1 4.3% (95% CI, 2.6-5.6), B 3.0% (95% CI, 0.8-4.9) and pH1N1 0.2% (95% CI, 0-0.4). During the height of influenza season, weekly attributable fractions reach 59%. While vaccination against meningococcal disease is the most important prevention strategy, influenza vaccination could provide further protection, particularly in young children where the meningococcal disease vaccine is not recommended or protective against the most common serogroup.

Dataset Information

Melanoma Thickness and Survival Trends in the United States, 1989 to 2009.

Background

Methods

Results

Conclusions

Publications

Melanoma Thickness and Survival Trends in the United States, 1989 to 2009.

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