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including a population with reports of invasive cutaneous melanoma in our hospital between January 1&#44; 2007&#44; through December 31&#44; 2016&#46; We excluded those with just in situ melanoma or a primary report of metastasis of melanoma&#46; The study population consisted of 163&#44;100 members of the HMCP&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We found 253 cutaneous malignant melanoma &#40;CMM&#41; cases&#44; witch 124 were females &#40;49&#46;0&#37;&#41;&#46; The median age at diagnosis was 69 years &#40;IQR 58&#8211;78&#41;&#44; and the average age at diagnosis was 66&#46;3 years &#40;SD&#61;15&#46;3&#41;&#46; This result is in line with the higher incidence of CMM&#44; as well as with other types of cancer&#44; in older people&#46; The average age of diagnosis for CMM worldwide is 57&#44; while our data show a mean age of 66&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The HCMP crude CMM incidence density rate &#40;IDR&#41; obtained was 19&#46;5 per 100&#44;000 person-years &#40;95&#37; CI 16&#46;3&#8211;21&#46;0&#41;&#46; The adjusted IDR for the BA population was 13&#46;4 per 100&#44;000 person-years &#40;95&#37; CI 11&#46;7&#8211;15&#46;2&#41;&#46; According to 2010 national demographic census data&#44; BA has a population of 2&#44;890&#44;151 inhabitants&#44; of which 30&#37; are &#60;25 years and 21&#46;7&#37; are &#62;60 years&#46; The distribution over age and gender strata are similar to the HMCP population &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> a and b&#41;&#46; The adjusted IDR for CMM for the population in Argentina is 10&#46;2 per 100&#44;000 person-years &#40;95&#37; CI 8&#46;7&#8211;11&#46;7&#41;&#44; almost half of the crude HCMP IDR&#46; This adjustment-based discrepancy can be attributed to the difference in the age distribution within the population under study&#44; in which 32&#37; of the members are over the age of 60 compared to the population of Argentina&#44; which only has 10&#46;2&#37; belonging to the same age group&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Prevalence was estimated considering the number of live cases up to July 1&#44; 2016&#44; divided by the number of active HCMP members at that time&#46; The prevalent cases were 193 out of 146&#44;524 HCMP members with a prevalence rate of 13&#46;2 per 100&#44;000 people &#40;95&#37; CI 11&#46;4&#8211;15&#46;2&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">When we analyze rates by gender&#44; the literature says that in young people the incidence of CMM is higher in women&#46; It is inverted in older people&#44; with the higher incidence being in men&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In our population&#44; we found a similar situation&#44; HCMP gender-specific crude IDRs were 23&#46;6 per 100&#44;000 person-years &#40;95&#37; CI 18&#46;7&#8211;26&#46;8&#41; for males and 15&#46;9 per 100&#44;000 person-years &#40;95&#37; CI 13&#46;1&#8211;18&#46;8&#41; for females&#46; The adjusted IDR for the BA population was 16&#46;3 per 100&#44;000 person-years &#40;95&#37; CI 12&#46;4&#8211;20&#46;2&#41; and 12&#46;3 per 100&#44;000 person-years &#40;95&#37; CI 9&#46;9&#8211;14&#46;6&#41;&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The incidence rate ratio &#40;IRR&#41; of the crude IDR for males compared to females was 1&#46;5 &#40;95&#37; CI 1&#46;2&#8211;1&#46;9&#59; p&#8239;&#61;&#8239;0&#46;0017&#41;&#46; This data suggests a higher probability of developing this type of tumor in men&#46; This is probably due to fewer prevention strategies since&#44; in our country&#44; men were the ones primarily exposed to the sun for work reasons in past decades&#46; In the meantime&#44; the population of women has started increasing in this regard due to tanning beds and intermittent sun exposure for recreational or beauty purposes&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;7</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">On a worldwide level&#44; we find a wide range of rates for CMM&#46; The annual incidence ranges from 0&#46;3 and 0&#46;2 per 100&#44;000 person-years in Asia and India&#44; respectively&#44; up to 55 per 100&#44;000 person-years in New Zealand&#44; a position held by Australia not long ago&#44; which has recently dropped to 54 per 100&#44;000 person-years&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> The most recent publications are from Germany and Canada&#44; where the crude IDR observed for the latter were 12&#46;3 cases per 100&#44;000 person-years and the ASIR &#40;age-standardized incidence rate&#41; for the population was 9&#46;6 cases per 100&#44;000 person-years&#46; According to these publications&#44; our adjusted IDR for CMM is similar to the German and Canadian populations&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In South America&#44; Brazil and Colombia have recently published data on this matter&#46; In 2016&#44; Brazil had an estimated annual melanoma incidence of 5&#46;8 cases per 100&#44;000 person-years&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;8&#44;10</span></a> Colombia had an ASIR of 1&#46;7 per 100&#44;000 person-years&#46; Both Brazil and Colombia have a greater proportion of populations of African descent compared to Argentina&#46; This could explain the differences in the rates of the CMM&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Since this is a review&#44; we had several limitations&#46; The validity of this study could be increased with the addition of information from other institutions from BA and representative regions nationwide to confirm the results and achieve a more accurate knowledge of melanoma epidemiology in Argentina&#46; However&#44; this is the first study of a large cohort of patients in Argentina that estimated the incidence of melanoma&#44; and these results are similar to those published for other similar geographical areas&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Financial support</span><p id="par0065" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Authors&#8217; contributions</span><p id="par0070" class="elsevierStylePara elsevierViewall">Adriana Raquel Rinflerch&#58; Conception and design of the study&#44; analysis&#44; and interpretation of data&#59; drafting the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Victoria Ines Volonteri&#58; Conception and design of the study&#59; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Mar&#237;a Cecilia Roude&#58; Acquisition of data&#59; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Vanina Laura Pagotto&#58; Analysis and interpretation of data&#59; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Melina Pol&#58; Acquisition of data&#59; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Luis Daniel Mazzuoccolo&#58; The conception and design of the study&#46;&#58; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec1015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1020">Acknowledgement</span><p id="par1100" class="elsevierStylePara elsevierViewall">This work was funded by grants from the <span class="elsevierStyleGrantSponsor" id="gs1">National Cancer Institute</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs1">INC 2018</span>&#41;&#44; and the <span class="elsevierStyleGrantSponsor" id="gs2">HIBA Dermatology Service</span>&#46;</p></span></span>"
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">10&#46;2 &#40;8&#46;7&#8211;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&#46;2 &#40;8&#46;6&#8211;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                            2 => "J&#46;V&#46; Schaffer"
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                            4 => "L&#46; Cerroni"
                            5 => "W&#46;R&#46; Heymann"
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Research Letter
Trends in melanoma incidence at Hospital Italiano de Buenos Aires, 2007–2016
Adriana Raquel Rinflercha,b,
Corresponding author
, Victoria Ines Volonteric, María Cecilia Roudeb, Laura Vanina Pagottod, Melina Pole, Luis Daniel Mazzuoccolob
a Instituto de Biología Subtropical CONICET, Universidad Nacional de Misiones, Misiones, Argentina
b Servicio de Dermatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
c Servicio Anatomía Patológica del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
d Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
e Servicio Anatomía Patológica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gender and age distribution of &#40;A&#41;&#44; Italian Hospital Medical Care Program and &#40;B&#41;&#44; Buenos Aires&#44; population according to 2010 national demographic census&#46; Male &#40;red&#41; Female &#40;blue&#41;&#46; The age of the population is grouped into periods of four years&#46; The quantities of people of each gender are expressed in percentage&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">There are three types of melanomas&#58; uveal&#44; mucosal&#44; and cutaneous&#46; Cutaneous melanoma is the most common subtype&#44; and it causes most skin cancer deaths&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Despite the fact that the risk factors for melanoma are known today and there are social prevention and advertising campaigns about skincare&#44; disease rates have increased worldwide in recent years&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The demographic distribution of melanoma incidence is directly related to environmental and genetic factors such as geographic sun intensity&#44; and skin phototypes of the population&#46; Immunosuppression and numerous episodes of sunburn increase the risk even more&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The Hospital Italiano de Buenos Aires is a private health care institution where approximately 300&#44;000 people from Buenos Aires City &#40;BA&#41; are treated annually&#46; Half of them are members of the prepaid Plan de Salud del Hospital Italiano de Buenos Aires &#40;Medical Care Program &#8211; HMCP&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> As little is known about melanoma incidence either in the BA or the Argentinean populations&#44; we sought to explore that incidence in our HMCP population&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The Hospital Italiano de Buenos Aires Clinical Research and Bioethics Committee approved this study&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Rates were reported with the corresponding 95&#37; Confidence Intervals &#40;CIs&#41;&#46; The differences were considered significant when the p-value was less than 0&#46;05&#59; STATA software &#40;Stata Corp LLC&#44; TX&#59; version 14&#46;2&#41; was used for calculations&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A retrospective cohort study was carried out&#44; including a population with reports of invasive cutaneous melanoma in our hospital between January 1&#44; 2007&#44; through December 31&#44; 2016&#46; We excluded those with just in situ melanoma or a primary report of metastasis of melanoma&#46; The study population consisted of 163&#44;100 members of the HMCP&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We found 253 cutaneous malignant melanoma &#40;CMM&#41; cases&#44; witch 124 were females &#40;49&#46;0&#37;&#41;&#46; The median age at diagnosis was 69 years &#40;IQR 58&#8211;78&#41;&#44; and the average age at diagnosis was 66&#46;3 years &#40;SD&#61;15&#46;3&#41;&#46; This result is in line with the higher incidence of CMM&#44; as well as with other types of cancer&#44; in older people&#46; The average age of diagnosis for CMM worldwide is 57&#44; while our data show a mean age of 66&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The HCMP crude CMM incidence density rate &#40;IDR&#41; obtained was 19&#46;5 per 100&#44;000 person-years &#40;95&#37; CI 16&#46;3&#8211;21&#46;0&#41;&#46; The adjusted IDR for the BA population was 13&#46;4 per 100&#44;000 person-years &#40;95&#37; CI 11&#46;7&#8211;15&#46;2&#41;&#46; According to 2010 national demographic census data&#44; BA has a population of 2&#44;890&#44;151 inhabitants&#44; of which 30&#37; are &#60;25 years and 21&#46;7&#37; are &#62;60 years&#46; The distribution over age and gender strata are similar to the HMCP population &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> a and b&#41;&#46; The adjusted IDR for CMM for the population in Argentina is 10&#46;2 per 100&#44;000 person-years &#40;95&#37; CI 8&#46;7&#8211;11&#46;7&#41;&#44; almost half of the crude HCMP IDR&#46; This adjustment-based discrepancy can be attributed to the difference in the age distribution within the population under study&#44; in which 32&#37; of the members are over the age of 60 compared to the population of Argentina&#44; which only has 10&#46;2&#37; belonging to the same age group&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Prevalence was estimated considering the number of live cases up to July 1&#44; 2016&#44; divided by the number of active HCMP members at that time&#46; The prevalent cases were 193 out of 146&#44;524 HCMP members with a prevalence rate of 13&#46;2 per 100&#44;000 people &#40;95&#37; CI 11&#46;4&#8211;15&#46;2&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">When we analyze rates by gender&#44; the literature says that in young people the incidence of CMM is higher in women&#46; It is inverted in older people&#44; with the higher incidence being in men&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In our population&#44; we found a similar situation&#44; HCMP gender-specific crude IDRs were 23&#46;6 per 100&#44;000 person-years &#40;95&#37; CI 18&#46;7&#8211;26&#46;8&#41; for males and 15&#46;9 per 100&#44;000 person-years &#40;95&#37; CI 13&#46;1&#8211;18&#46;8&#41; for females&#46; The adjusted IDR for the BA population was 16&#46;3 per 100&#44;000 person-years &#40;95&#37; CI 12&#46;4&#8211;20&#46;2&#41; and 12&#46;3 per 100&#44;000 person-years &#40;95&#37; CI 9&#46;9&#8211;14&#46;6&#41;&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The incidence rate ratio &#40;IRR&#41; of the crude IDR for males compared to females was 1&#46;5 &#40;95&#37; CI 1&#46;2&#8211;1&#46;9&#59; p&#8239;&#61;&#8239;0&#46;0017&#41;&#46; This data suggests a higher probability of developing this type of tumor in men&#46; This is probably due to fewer prevention strategies since&#44; in our country&#44; men were the ones primarily exposed to the sun for work reasons in past decades&#46; In the meantime&#44; the population of women has started increasing in this regard due to tanning beds and intermittent sun exposure for recreational or beauty purposes&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;7</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">On a worldwide level&#44; we find a wide range of rates for CMM&#46; The annual incidence ranges from 0&#46;3 and 0&#46;2 per 100&#44;000 person-years in Asia and India&#44; respectively&#44; up to 55 per 100&#44;000 person-years in New Zealand&#44; a position held by Australia not long ago&#44; which has recently dropped to 54 per 100&#44;000 person-years&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> The most recent publications are from Germany and Canada&#44; where the crude IDR observed for the latter were 12&#46;3 cases per 100&#44;000 person-years and the ASIR &#40;age-standardized incidence rate&#41; for the population was 9&#46;6 cases per 100&#44;000 person-years&#46; According to these publications&#44; our adjusted IDR for CMM is similar to the German and Canadian populations&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In South America&#44; Brazil and Colombia have recently published data on this matter&#46; In 2016&#44; Brazil had an estimated annual melanoma incidence of 5&#46;8 cases per 100&#44;000 person-years&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;8&#44;10</span></a> Colombia had an ASIR of 1&#46;7 per 100&#44;000 person-years&#46; Both Brazil and Colombia have a greater proportion of populations of African descent compared to Argentina&#46; This could explain the differences in the rates of the CMM&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Since this is a review&#44; we had several limitations&#46; The validity of this study could be increased with the addition of information from other institutions from BA and representative regions nationwide to confirm the results and achieve a more accurate knowledge of melanoma epidemiology in Argentina&#46; However&#44; this is the first study of a large cohort of patients in Argentina that estimated the incidence of melanoma&#44; and these results are similar to those published for other similar geographical areas&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Financial support</span><p id="par0065" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Authors&#8217; contributions</span><p id="par0070" class="elsevierStylePara elsevierViewall">Adriana Raquel Rinflerch&#58; Conception and design of the study&#44; analysis&#44; and interpretation of data&#59; drafting the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Victoria Ines Volonteri&#58; Conception and design of the study&#59; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Mar&#237;a Cecilia Roude&#58; Acquisition of data&#59; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Vanina Laura Pagotto&#58; Analysis and interpretation of data&#59; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Melina Pol&#58; Acquisition of data&#59; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Luis Daniel Mazzuoccolo&#58; The conception and design of the study&#46;&#58; draft the article and revising it critically for important intellectual content&#59; final approval of the version to be submitted&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec1015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1020">Acknowledgement</span><p id="par1100" class="elsevierStylePara elsevierViewall">This work was funded by grants from the <span class="elsevierStyleGrantSponsor" id="gs1">National Cancer Institute</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs1">INC 2018</span>&#41;&#44; and the <span class="elsevierStyleGrantSponsor" id="gs2">HIBA Dermatology Service</span>&#46;</p></span></span>"
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Article information
ISSN: 03650596
Original language: English
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