Improving survival of melanoma patients in Europe since 1978. EUROCARE Working Group.

Within the EUROCARE study 45 cancer registries have contributed survival data on 3.5 million cancer sufferers within 17 countries in Europe. This paper reports on survival in 16,113 cutaneous malignant melanoma cases diagnosed between 1985 and 1989. Relative survival rates were calculated according to the Hakulinen computer program with data stratified according to country, age group and period of diagnosis. Relative 5-year survival was higher in women (81%) than in men (69%) but there was wide variation in relative survival across Europe at both 1 and 5 years, ranging at 5 years between 54 and 89%. At both 1 and 5 years, survival was lowest in the Eastern countries. Between 1978 and 1989 there was an improvement in survival rates probably attributable to the detection of increasing proportions of better prognosis, thinner tumours. In the younger age groups, this may be related to public awareness campaigns. The discrepancy in survival between men and women also narrowed. The single most important prognostic factor is the depth of invasion at diagnosis and there is some evidence that underlying variation in stage at presentation as well as histological type accounts for much of the observed variation in survival.