Trends in short-term survival from distant-stage cutaneous melanoma in the United States, 2001-2013 (CONCORD-3)

Veronica Di Carlo; Jacques Estève; Christopher Johnson; Fabio Girardi; Hannah K Weir; Reda J Wilson; Pamela Minicozzi; Rosemary D Cress; Charles F Lynch; Karen S Pawlish; Judith R Rees; Michel P Coleman; Claudia Allemani; US CONCORD Working Group

doi:10.1093/JNCICS/PKAA078

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Trends in short-term survival from distant-stage cutaneous melanoma in the United States, 2001-2013 (CONCORD-3)

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Trends in short-term survival from distant-stage cutaneous melanoma in the United States, 2001-2013 (CONCORD-3)

Veronica Di Carlo, Jacques Estève, Christopher Johnson, Fabio Girardi, Hannah K Weir, Reda J Wilson, Pamela Minicozzi, Rosemary D Cress, Charles F Lynch, Karen S Pawlish, …

JNCI cancer spectrum, Vol.4(6), pp.pkaa078-pkaa078

12/2020

DOI: 10.1093/JNCICS/PKAA078

PMCID: PMC7771008

PMID: 33409455

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Abstract

Survival from metastatic cutaneous melanoma is substantially lower than for localized disease. Treatments for metastatic melanoma have been limited, but remarkable clinical improvements have been reported in clinical trials in the last decade. We described the characteristics of US patients diagnosed with cutaneous melanoma during 2001-2013 and assessed trends in short-term survival for distant-stage disease. Trends in 1-year net survival were estimated using the Pohar Perme estimator, controlling for background mortality with life tables of all-cause mortality rates by county of residence, single year of age, sex, and race for each year 2001-2013. We fitted a flexible parametric survival model on the log-hazard scale to estimate the effect of race on the hazard of death because of melanoma and estimated 1-year net survival by race. Only 4.4% of the 425 915 melanomas were diagnosed at a distant stage, cases diagnosed at a distant stage are more commonly men, older patients, and African Americans. Age-standardized, 1-year net survival for distant-stage disease was stable at approximately 43% during 2001-2010. From 2010 onward, survival improved rapidly, reaching 58.9% (95% confidence interval = 56.6% to 61.2%) for patients diagnosed in 2013. Younger patients experienced the largest improvement. Survival for distant-stage disease increased in both Blacks and Whites but was consistently lower in Blacks. One-year survival for distant-stage melanoma improved during 2001-2013, particularly in younger patients and those diagnosed since 2010. This improvement may be a consequence of the introduction of immune-checkpoint-inhibitors and other targeted treatments for metastatic and unresectable disease. Persistent survival inequalities exist between Blacks and Whites, suggesting differential access to treatment.

Details

Title: Subtitle: Trends in short-term survival from distant-stage cutaneous melanoma in the United States, 2001-2013 (CONCORD-3)
Creators: Veronica Di Carlo - Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
Jacques Estève - Université Claude Bernard, Hospices Civils de Lyon, Service de Biostatistique, Lyon Cedex 03, France
Christopher Johnson - Cancer Data Registry of Idaho, Boise, ID, USA
Fabio Girardi - Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
Hannah K Weir - Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
Reda J Wilson - Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
Pamela Minicozzi - Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
Rosemary D Cress - Public Health Institute, Cancer Registry of Greater California, Sacramento, CA, USA
Charles F Lynch - Department of Epidemiology, University of Iowa, Iowa City, IA, USA
Karen S Pawlish - New Jersey Department of Health, Trenton, NJ, USA
Judith R Rees - Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
Michel P Coleman - Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
Claudia Allemani - Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
US CONCORD Working Group
Resource Type: Journal article
Publication Details: JNCI cancer spectrum, Vol.4(6), pp.pkaa078-pkaa078
DOI: 10.1093/JNCICS/PKAA078
PMID: 33409455
PMCID: PMC7771008
NLM abbreviation: JNCI Cancer Spectr
ISSN: 2515-5091
eISSN: 2515-5091
Grant note: P30 CA086862 / NCI NIH HHS
Language: English
Date published: 12/2020
Academic Unit: Epidemiology
Record Identifier: 9984214675902771

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