Analysis of Breslow tumor thickness distribution of skin melanoma in the Italian region of Romagna, 1986-1991

Aims and background: In southern European countries, the availability of epidemiologic data on cutaneous malignant melanoma is limited. A descriptive analysis was performed on melanoma cases diagnosed in the Italian region of Romagna (population 600,000), 1986-91. Methods: The main end point was the proportion of cases less than 1.5 mm thick by sex, age, and site. Results: A total of 297 incident cases was evaluated. The average annual age-standardized (World) incidence rates were 6.2 (95% Cl 5.2-7.2) per 100,000 females and 4.5 (95% Cl 3.6-5.3) per 100,000 males. Females presented with significantly thinner melanomas than males. The proportion of cases less than 1.5 mm thick decreased significantly with increasing age in both sexes, with the most pronounced decrease (approximately from 2/3 to 1/3) being observed above 60 years for females and above 40 for males. Comparing sexes by 10-year age groups, a significant F:M advantage in thickness distribution was found only at age 40-49 and 50-59 years. Among females under 60, melanomas of the legs and those of the trunk showed no difference in thickness distribution. In both sexes, incidence appeared to increase progressively with age. No apparent elevation in incidence rates was observed in the age groups with the highest frequency of thin melanomas. Conclusions: The major implication of these data is that in public education programs specific messages should be aimed at those subgroups that show the poorest levels of self-surveillance.