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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 2017 Mar 14

DOI: 10.23736/S0392-0488.17.05584-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Thick melanoma in Tuscany

Alessandra CHIARUGI 1 , Paolo NARDINI 1, Lorenzo BORGOGNONI 2, Paola BRANDANI 2, Gianni GERLINI 2, Pietro RUBEGNI 3, Arianna LAMBERTI 3, Camilla SALVINI 4, Giovanni Lo SCOCCO 4, Roberto CECCHI 5, Riccardo SIRNA 6, Stefano LORENZI 7, Riccardo GATTAI 8, Silvio BATTISTINI 9, Emanuele CROCETTI 10

1 Secondary Prevention Unit, ISPO, Institute for Oncological Study and Prevention, Florence, Italy; 2 Unit of Plastic and Reconstructive Surgery, Regional Melanoma Referral Center, S.M. Annunziata Hospital, AUSL Toscana Centro, Florence, Italy; 3 Department of Medical, Surgical Sciences and Neurosciences, Section of Dermatology, AUSL Toscana Sud-Est, Siena, Italy; 4 U.O.S.D. Dermatology, AUSL Toscana Centro, Prato Hospital, Prato, Italy; 5 UO Dermatology, S. Jacopo Hospital, AUSL Toscana Centro, Pistoia, Italy; 6 U.O.C. Dermatology, Misericordia Hospital Grosseto, AUSL Toscana Sud-Est, Grosseto, Italy; 7 U.O.Dermatology S. Luca Hospital, AUSL Toscana Nord-Ovest, Lucca, Italy; 8 Department of Surgery and Translational Medicine, University of Florence, Florence, Italy; 9 U.O Dermatology, AUSL Toscana Nord-Ovest, Massa Carrara, Italy; 10 Romagna Cancer Registry, Romagna Cancer Institute (IRST) IRCCS, Meldola, Forlì-Cesena, Italy


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BACKGROUND: The epidemiologic trends of cutaneous melanoma are similar in several countries with a Western-type life style, where there is a progressive increasing incidence and a low but not decreasing mor- tality, or somewhere an increase too, especially in the older age groups. Also in Tuscany there is a steady rise in incidence with prevalence of in situ and invasive thin melanomas, with also an increase of thick melanomas. It is necessary to reduce the frequency of thick melanomas to reduce specific mortality.
OBJECTIVE AND METHODS: The objective of the current survey has been to compare, in the Tuscany population, by a case- case study, thin and thick melanoma cases, trying to find out those personal and tumour characteristics which may help to customize preventive interventions.
RESULTS The results confirmed the age and the lower edu- cation level are associated with a later detection. The habit to perform skin self-examination is resulted protec- tive forward thick melanoma and also the diagnosis by a doctor. The elements emerging from the survey allow to hypothesize a group of subjects resulting at higher risk for a late diagnosis, aged over 50 and carrier of a fewer constitutional and environmental risk factors: few total and few atypical nevi, and lower sun exposure and burning. It is assumable that a part of people did not be reached from messages of prevention because does not recognize oneself in the categories of people at risk for skin cancers described in educational cam- paigns.
CONCLUSIONS: If we want to obtain better results on diagnosis of skin melanoma we have to think a new strategy. At least to think over the educational messages discriminating people more at risk of incidence of melanoma from people more at risk to die from melanoma, and to renewed active involvement of the Gen- eral Practitioners .


KEY WORDS: Thick melanoma - Prevention melanoma campaigns - Early diagnosis melanoma - Risk factors for melanoma

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a.chiarugi@ispo.toscana.it