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Regional and socioeconomic variation in survival of melanoma patients in Denmark

Research output: Contribution to journalArticle

Marianne Steding-Jessen, Henriette Engberg, Inge Øster, Jens Winther Jensen, Lisbet Rosenkrantz Hölmich, Henrik Møller

Original languageEnglish
Article numberA5572
JournalDanish Medical Journal
Volume66
Issue number11
Publication statusPublished - Nov 2019

Bibliographical note

Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

King's Authors

Abstract

INTRODUCTION: This article explores variation in survival and mortality of Danish melanoma patients from 2012 to 2017 in relation to their region of residence and socioeconomic status. METHODS: Data were extracted from The Danish Melanoma Database, a clinical register, based on reports from hospital departments and dermatologists, and designed for quality improvement. The analysis included covariates at the person and tumour level. A cohort analysis was implemented to quantify the variations and identify the underlying mechanisms behind regional and socioeconomic variations in mortality of melanoma patients. RESULTS: The mortality of melanoma patients varied between the five regions with mean hazard ratios (95% confidence interval) of 1.36 (1.07-1.74) in men and 1.44 (1.08- 1.92) in women between the regions with highest and lowest mortality. Mortality was highest in the patients with the lowest income and shortest education. Regional variation in mortality was attributable to underlying variation in tumour stage and thickness, and it was not confounded by other covariates. CONCLUSIONS: The two regions with the lowest mortality (highest survival) had high absolute incidence rates of stage IA and thin melanomas, indicating a high level of diagnostic activity in these regions. There was no regional variation in the incidence of advanced melanoma. The optimal level of diagnostic investigation of skin lesions has yet to be established.

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