Prognostic factors and disease-specific survival among immigrants diagnosed with cutaneous malignant melanoma in Sweden
International Journal of Cancer, March 2016
Simberg‐Danell, Caroline, Lyth, Johan, Månsson‐Brahme, Eva, Frohm‐Nilsson, Margareta, Carstensen, John, Hansson, Johan, Eriksson, Hanna
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 and stage and CMM prognosis, respectively. stage. After adjustments for confounders, first generation immigrant 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 to 3.50. Stage III-IV vs I: OR=2.40, 95% CI = 1.08-5.37). stageThe ORsof stage II-IV vs stage I disease were increased among men (OR=1.9; 95% CI=1.1 - 3.3; P=0.020), and inwomen (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. In conclusion, the CMM-specific survival was significantly decreased among women from former Yugoslavia compared to Swedish-born women (hazard ratio (HR) = 2.2; 95% CI=1.1 - 4.2; P=0.043). After additional adjustment including stage, the survival difference was no longer significant. No survival difference between the second generation immigrant group and Swedish-born patients were observed. 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 CMM prognosis. This article is protected by copyright. All rights reserved.
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