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Melanoma incidence, recurrence, and mortality in an integrated healthcare system: A retrospective cohort study

BACKGROUND: Numerous studies have examined melanoma incidence and survival, but studies on melanoma recurrence are limited. We examined melanoma incidence, recurrence, and mortality among members of Kaiser Permanente Colorado (KPCO) between January 1, 2000 and December 31, 2015. METHODS: Age‐adjuste...

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Autores principales: Feigelson, Heather S., Powers, John D., Kumar, Mayanka, Carroll, Nikki M., Pathy, Arun, Ritzwoller, Debra P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6675720/
https://www.ncbi.nlm.nih.gov/pubmed/31215776
http://dx.doi.org/10.1002/cam4.2252
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author Feigelson, Heather S.
Powers, John D.
Kumar, Mayanka
Carroll, Nikki M.
Pathy, Arun
Ritzwoller, Debra P.
author_facet Feigelson, Heather S.
Powers, John D.
Kumar, Mayanka
Carroll, Nikki M.
Pathy, Arun
Ritzwoller, Debra P.
author_sort Feigelson, Heather S.
collection PubMed
description BACKGROUND: Numerous studies have examined melanoma incidence and survival, but studies on melanoma recurrence are limited. We examined melanoma incidence, recurrence, and mortality among members of Kaiser Permanente Colorado (KPCO) between January 1, 2000 and December 31, 2015. METHODS: Age‐adjusted incidence rates were computed to examine trends among KPCO members aged 21 years and older. Cox proportional hazards models were used to examine factors associated with recurrence and mortality. RESULTS: Our cohort included 1931 cases of invasive melanoma. Incidence rates increased over time and were higher than SEER rates; however, the increase was limited to early stage disease. In multivariable models, stage at initial diagnosis, gender, and age were associated with melanoma recurrence. Men were more likely to have a recurrence than women (adjusted hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.19‐2.43), and for each decade of increasing age, the adjusted HR = 1.20 (95% CI: 1.06‐1.37). Factors associated with all‐cause mortality included stage (HR = 12.87, 95% CI: 6.63‐24.99, for stage IV vs stage I), male gender (HR = 1.42, 95% CI: 1.12‐1.79), older age at diagnosis, lower socioeconomic status, and comorbidity index. For melanoma‐specific mortality, results were similar, with one exception: age was not associated with melanoma‐specific death (HR = 1.09, 95% CI: 0.94‐1.25, P = 0.253). CONCLUSIONS: Data derived from an insured patient population, such as KPCO, have the potential to enhance our understanding of emerging trends in melanoma. This is the first population‐based study in the United States to examine patient characteristics associated with risk of recurrence. Men have an increased risk of both recurrence and death, and thus may benefit from more intensive follow‐up than women.
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spelling pubmed-66757202019-08-06 Melanoma incidence, recurrence, and mortality in an integrated healthcare system: A retrospective cohort study Feigelson, Heather S. Powers, John D. Kumar, Mayanka Carroll, Nikki M. Pathy, Arun Ritzwoller, Debra P. Cancer Med Cancer Prevention BACKGROUND: Numerous studies have examined melanoma incidence and survival, but studies on melanoma recurrence are limited. We examined melanoma incidence, recurrence, and mortality among members of Kaiser Permanente Colorado (KPCO) between January 1, 2000 and December 31, 2015. METHODS: Age‐adjusted incidence rates were computed to examine trends among KPCO members aged 21 years and older. Cox proportional hazards models were used to examine factors associated with recurrence and mortality. RESULTS: Our cohort included 1931 cases of invasive melanoma. Incidence rates increased over time and were higher than SEER rates; however, the increase was limited to early stage disease. In multivariable models, stage at initial diagnosis, gender, and age were associated with melanoma recurrence. Men were more likely to have a recurrence than women (adjusted hazard ratio [HR]: 1.70, 95% confidence interval [CI]: 1.19‐2.43), and for each decade of increasing age, the adjusted HR = 1.20 (95% CI: 1.06‐1.37). Factors associated with all‐cause mortality included stage (HR = 12.87, 95% CI: 6.63‐24.99, for stage IV vs stage I), male gender (HR = 1.42, 95% CI: 1.12‐1.79), older age at diagnosis, lower socioeconomic status, and comorbidity index. For melanoma‐specific mortality, results were similar, with one exception: age was not associated with melanoma‐specific death (HR = 1.09, 95% CI: 0.94‐1.25, P = 0.253). CONCLUSIONS: Data derived from an insured patient population, such as KPCO, have the potential to enhance our understanding of emerging trends in melanoma. This is the first population‐based study in the United States to examine patient characteristics associated with risk of recurrence. Men have an increased risk of both recurrence and death, and thus may benefit from more intensive follow‐up than women. John Wiley and Sons Inc. 2019-06-19 /pmc/articles/PMC6675720/ /pubmed/31215776 http://dx.doi.org/10.1002/cam4.2252 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cancer Prevention
Feigelson, Heather S.
Powers, John D.
Kumar, Mayanka
Carroll, Nikki M.
Pathy, Arun
Ritzwoller, Debra P.
Melanoma incidence, recurrence, and mortality in an integrated healthcare system: A retrospective cohort study
title Melanoma incidence, recurrence, and mortality in an integrated healthcare system: A retrospective cohort study
title_full Melanoma incidence, recurrence, and mortality in an integrated healthcare system: A retrospective cohort study
title_fullStr Melanoma incidence, recurrence, and mortality in an integrated healthcare system: A retrospective cohort study
title_full_unstemmed Melanoma incidence, recurrence, and mortality in an integrated healthcare system: A retrospective cohort study
title_short Melanoma incidence, recurrence, and mortality in an integrated healthcare system: A retrospective cohort study
title_sort melanoma incidence, recurrence, and mortality in an integrated healthcare system: a retrospective cohort study
topic Cancer Prevention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6675720/
https://www.ncbi.nlm.nih.gov/pubmed/31215776
http://dx.doi.org/10.1002/cam4.2252
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