International Journal of Cancer
Volume 139, Issue 3, 2016, Pages 543-553

Prognostic factors and disease-specific survival among immigrants diagnosed with cutaneous malignant melanoma in Sweden (Article)

Simberg-Danell C. , Lyth J. , Mänsson-Brahme E. , Frohm-Nilsson M. , Carstensen J. , Hansson J. , Eriksson H.*
  • a Department of Oncology and Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, SE-171 76, Sweden, Department of Dermatology and Venereology, Södersjukhuset, Stockholm, SE 118 83, Sweden
  • b Unit of Research and Development in Local Health Care, County of Östergötland, Linköping, Sweden
  • c Department of Oncology and Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, SE-171 76, Sweden, Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, SE 171 76, Sweden
  • d Department of Medicine, Unit of Dermatology, Karolinska University Hospital, Stockholm, SE, 171 76, Sweden
  • e Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  • f Department of Oncology and Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, SE-171 76, Sweden, Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, SE 171 76, Sweden
  • g Department of Oncology and Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, SE-171 76, Sweden, Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, SE 171 76, Sweden

Abstract

Little is known about cutaneous malignant melanoma (CMM) among immigrants in Europe. We aimed to investigate clinical characteristics and disease-specific survival among first- and second-generation immigrants in Sweden. This nationwide population-based study included 27,235 patients from the Swedish Melanoma Register diagnosed with primary invasive CMM, 1990-2007. Data were linked to nationwide, population-based registers followed up through 2013. Logistic regression and Cox regression models were used to determine the association between immigrant status, stage and CMM prognosis, respectively. After adjustments for confounders, first generation immigrants from Southern Europe were associated with significantly more advanced stages of disease compared to Swedish-born patients [Stage II vs. I: Odds ratio (OR) = 2.37, 95% CI = 1.61-3.50. Stage III-IV vs I: OR = 2.40, 95% CI = 1.08-5.37]. The ORs of stage II-IV versus stage I disease were increased among men (OR = 1.9; 95% CI = 1.1-3.3; p = 0.020), and women (OR = 4.8; 95% CI = 2.6-9.1; p < 0.001) in a subgroup of immigrants from former Yugoslavia compared to Swedish-born patients. The CMM-specific survival was significantly decreased among women from former Yugoslavia versus Swedish-born women [hazard ratio (HR)=2.2; 95% CI = 1.1-4.2; p = 0.043]. After additional adjustments including stage, the survival difference was no longer significant. No survival difference between the second generation immigrant group and Swedish-born patients were observed. In conclusion, a worse CMM-specific survival in women from former Yugoslavia was associated with more advanced stages of CMM at diagnosis. Secondary prevention efforts focusing on specific groups may be needed to further improve the CMM prognosis. © 2016 UICC.

Author Keywords

immigrants cutaneous malignant melanoma nationwide Population-based Prognosis

Index Keywords

immigrant cutaneous melanoma disease specific survival Kaplan-Meier Estimate tumor invasion Neoplasm Metastasis Registries cancer prognosis survival analysis Follow-Up Studies Swedish citizen register Neoplasm Staging human follow up middle aged Odds Ratio clinical feature Population Surveillance controlled study priority journal cancer staging Aged melanoma Yugoslavia prognosis Young Adult Sweden Humans migrant secondary prevention male Emigrants and Immigrants female Aged, 80 and over Socioeconomic Factors very elderly geographic origin socioeconomics population research cancer registry Article Southern Europe major clinical study metastasis adult Kaplan Meier method mortality advanced cancer health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84964318966&doi=10.1002%2fijc.30103&partnerID=40&md5=37c6c60b31e5e83dd90095570ff17684
DOI: 10.1002/ijc.30103
ISSN: 00207136
Cited by: 5
Original Language: English