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Prognostic factors and disease-specific survival among immigrants diagnosed with cutaneous malignant melanoma in Sweden
Karolinska Institute, Sweden; Soder Sjukhuset, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Faculty of Medicine and Health Sciences.
Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
Karolinska University Hospital, Sweden.
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2016 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 139, no 3, 543-553 p.Article in journal (Refereed) PublishedText
Abstract [en]

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; pamp;lt;0.001) in a subgroup of immigrants from former Yugoslavia compared to Swedish-horn patients. The CMM-specific survival was significantly decreased among women from former Yugoslavia versus Swedish-born women [hazard ratio (HR)=2.2; 95 h 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.

Place, publisher, year, edition, pages
WILEY-BLACKWELL , 2016. Vol. 139, no 3, 543-553 p.
Keyword [en]
cutaneous malignant melanoma; population-based; prognosis; immigrants; nationwide
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-130258DOI: 10.1002/ijc.30103ISI: 000378418100007PubMedID: 27004457OAI: oai:DiVA.org:liu-130258DiVA: diva2:950670
Note

Funding Agencies|Swedish Cancer Society [CAN 2010/225, CAN 2011/883]; Radiumhemmet Research [124083, 124092]; Sigurd and Elsa Golijes Memorial Foundation [LA2012-0112]; Stockholm County Council [20100032]

Available from: 2016-08-01 Created: 2016-07-28 Last updated: 2016-08-01

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Lyth, JohanCarstensen, John
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