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Melanoma prognosis in E urope: far from equal
Author(s) -
Forsea A.M.,
Marmol V.,
Stratigos A.,
Geller A.C.
Publication year - 2014
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.12923
Subject(s) - per capita , melanoma , demography , incidence (geometry) , medicine , mortality rate , population , proxy (statistics) , geography , environmental health , statistics , cancer research , physics , mathematics , sociology , optics
Summary Background Comprehensive, population‐based analysis of melanoma survival throughout E urope is hindered by the uneven coverage and quality of E uropean cancer registries, and by logistical and financial shortcomings. Mortality‐to‐incidence ratios ( MIR s) have been used as a proxy for estimating survival for multiple cancers and to model melanoma prognosis, higher MIR values reflecting poorer prognosis. Updated and improved pan‐ E uropean estimates of mortality and incidence rates for melanoma have become available through the I nternational A gency for R esearch of C ancer project G lobocan 2008, showing marked differences among E uropean countries. Objectives To analyse MIR s for melanoma across Europe and their relationship with national health expenditures, aiming to identify countries and regions with disproportionately poor prognosis. Methods Estimated age‐standardized rates of melanoma incidence and mortality provided by G lobocan 2008 were used to calculate the MIR for each E uropean country and region. Total health expenditures per capita in E uropean countries for 2008 were provided by the W orld H ealth O rganization/ G lobal H ealth O bservatory. The potential correlation between MIR and total health expenditure per capita was analysed through P earson's correlation. Results Mortality‐to‐incidence ratios for melanoma ranged between 0·09 in S witzerland and 0·44 in L atvia. The regional average MIR was the highest in C entral and E astern E urope at 0·35; the lowest was in W estern E urope, at 0·13. We found a strong inverse correlation between the individual nation's total health expenditure per capita and the calculated melanoma MIR ( r = –0·76, P < 0·05). Conclusions While further improvement of melanoma registration is necessary, our findings reveal sharp disparities in the prognosis of melanoma across the C ontinent, correlated with significant differences in health care expenditures.