Incidence and survival of skin melanoma in Puglia: A comparison with the rest of Italy

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Introduction: There is a wide heterogeneity in incidence, prevalence, mortality and survival of skin melanoma through the world and in Italy as well. In this study we investigated, for the first time, incidence, mortality and survival of skin melanoma in Puglia, comparing results with Italian data. Materials and methods: We collected accurate information about clinical and pathological variables, and measured crude and age-adjusted incidence and mortality rates, and estimated relative and net survival according to Ederer II and Pohar-Perme methods, respectively. Incidence, mortality and survival were performed by district and for the whole Puglia region; internal and external comparisons were done. Results: Age-adjusted incidence rates per 100,000 inhabitants in males were: Puglia 9.9 (95% confidence interval [CI] 9.1 to 10.8), AIRTUM Italy (AIRTUM pool) 12.0 (95% CI 11.6 to 12.4), Pool of Southern Italian registries (South pool) 7.1 (95% CI 6.6 to 7.6); in females: Puglia 9.7 (95% CI 8.9 to 10.6), AIRTUM pool 11.3 (95% CI 10.9 to 11.7), South pool 6.5 (95% CI 6.0 to 7.0). Age- standardized mortality rates per 100,000 inhabitants were in males and females in Puglia respectively 2.4 (95% CI 2.0 to 2.8) and 1.6 (95% CI 1.3 to 1.9). 5 years age-standardized relative survival was as follows: in males Puglia 81.4% (95% CI 77.0 to 85.0), Italy 81.6% (95% CI 80.4 to 82.8); in females Puglia 87.3% (95% CI 83.3 to 90.4), Italy 88.6% (95% CI 87.6 to 89.6). Conclusions: Incidence of skin melanoma is higher in Puglia compared with the southern Italy pool and lower compared with the other three Italian macro-areas (central, north-western and north-eastern Italy),but there are not statistically significant differences. A North to South gradient of melanoma skin is showed also in Puglia, except for Bari district where incidence is higher probably due to greater availability of public and private diagnostic centres. Overall mortality and survival in Puglia are very close to Italian estimates. The highest mortality is registered in males in BAT district where also the lowest survival is observed.

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