Skin melanoma survival is improving in Europe but regional differences persist: Results of the EUROCARE-6 study.
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BACKGROUND: The aim of this study was to update previous EUROCARE survival estimates for skin melanoma (SM) monitoring trends and survival differences between European regions. METHODS: 1-year, 5-year, and 5-year/1-year conditional age-standardised relative survival (ASRS) and geographical comparisons were estimated on 280,498 patients participating in the EUROCARE-6 project (>=15 years old) with invasive SM (diagnosed 2008-2013; followed-up till 2014), applying a complete cohort approach. Survival time trends during 2003-2011 were analysed using the period approach for 306,715 patients. Survival analysis was estimated by age, gender, anatomical sub-sites and morphology subgroups. RESULTS: Among European patients 5-year ASRS estimate was 87.9 % (95 % confidence interval, CI 87.7-88.1 %). The highest values were measured in Central Europe (91.2 %; 90.9-91.6 %), Northern Europe (90.3 %; 89.7-90.9 %), Ireland and United Kingdom (89.2 %; 88.9-89.6 %), followed by Southern Europe (85.7 %; 85.2-86.2 %), while the lowest survival value was observed in Eastern Europe (75.0 %; 74.2-75.7 %). Within regions, the intercountry absolute difference in 5-year ASRS percentage points varied from 2.9 % (Northern Europe) to 24.7 % (Eastern Europe). Five-year RS was higher in women than men and decreased with patients' advancing age. Differences emerged in terms of SM morphology and skin sub-sites. Survival slightly increased from 2003 to 2011, with a small improvement in Northern and the most pronounced one in Eastern Europe and Ireland and UK. DISCUSSION: In Europe SM survival is high and still increasing. The gap between European average survival value and Eastern European countries is still present and has not diminished significantly yet. Improvements are needed in the whole SM clinical path, from diagnosis to therapy, to overcome differences across countries.