Cutaneous melanoma attributable to UVR exposure in Denmark and Germany

Ulrike Keim; Sara Gandini; Teresa Amaral; Alexander Katalinic; Bernd Holleczek; Lukas Flatz; Ulrike Leiter; David Whiteman; Claus Garbe

doi:10.1016/j.ejca.2021.09.044

Cutaneous melanoma attributable to UVR exposure in Denmark and Germany

Ulrike Keim, Sara Gandini, Teresa Amaral, Alexander Katalinic, Bernd Holleczek, Lukas Flatz, Ulrike Leiter, David Whiteman, Claus Garbe^*

^*Corresponding author for this work

25 Citations (Scopus)

Abstract

Background: Increasing incidence rates of cutaneous melanoma (CM) observed during the last five decades in white populations are largely attributed to increased exposure to solar ultraviolet radiation (UVR), often expressed as population attributable fraction (PAF). Thus, many CMs could be prevented by reducing UVR exposure. The aim of this study was to estimate the PAF of CM attributable to UVR exposure and demographic changes in Denmark and Saarland/Germany for the period 1943 to 2036. Material and methods: CM incidence data (ICD-10, C43) for Denmark (1943–2016) and the German Federal State of Saarland (1972–2016) were retrieved from the NORDCAN database and from the Saarland Cancer Registry. The number of CMs attributable to UVR exposure was calculated by comparing contemporary or predicted CM incidence rates with CM rates in Denmark during the years 1943–1946. Results: In Denmark, the proportion of CM cases attributable to UVR exposure increased from around 20% in 1947–1951 to 96% in 2012–2016; in the Federal State of Saarland, it increased from 50% in 1972–1976 to 90% in 2012–2016. Until 2032–2036, the PAF is expected to rise in Denmark to 97% and in the Saarland to 92%. The demographic influence, on the other hand, is rather small. Conclusions: More than 90% of all CM in Germany and Denmark are attributable to UVR exposure, and in principle, preventable. These findings underline the need for primary prevention strategies, aiming to increase the awareness of melanoma and its risk factors and to promote behavioural changes that decrease sun exposure.

Original language	English
Journal	European Journal of Cancer
Volume	159
Pages (from-to)	98-104
Number of pages	7
ISSN	0959-8049
DOIs	https://doi.org/10.1016/j.ejca.2021.09.044
Publication status	Published - 12.2021

Funding

Dr. Whiteman reports grants from National Health and Medical Research Council of Australia, personal fees from Pierre Fabre, outside the submitted work. DW is funded by a Research Fellowship from the National Health and Medical Research Council of Australia [APP1155413].Dr. Amaral reports grants from Neracare, grants from Novartis, grants from SkylineDx, personal fees and travel support from BMS, travel support from Novartis, personal fees from CeCaVa, outside the submitted work.Dr. Flatz reports grants from Swiss Cancer League, grants from Hookipa Pharma, other from Novartis, other from Sanofi, other from Bristol-Myers Squibb, outside the submitted work; In addition, Dr. Flatz has a patent Arenavirus Particles to treat solid tumours licensed to WO2018/185307A1, a patent Prime-boost vaccination for viral infections licensed to WO2012162428A1, and a patent Replication-defective arenavirus vectors licensed to WO2009083210A1, outside the submitted work. Dr. Amaral reports grants from Neracare , grants from Novartis , grants from SkylineDx , personal fees and travel support from BMS, travel support from Novartis, personal fees from CeCaVa, outside the submitted work.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Research Areas and Centers

Research Area: Center for Population Medicine and Public Health (ZBV)

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10.1016/j.ejca.2021.09.044

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@article{45ac759a182a4ee69ebafa362ac7692f,

title = "Cutaneous melanoma attributable to UVR exposure in Denmark and Germany",

abstract = "Background: Increasing incidence rates of cutaneous melanoma (CM) observed during the last five decades in white populations are largely attributed to increased exposure to solar ultraviolet radiation (UVR), often expressed as population attributable fraction (PAF). Thus, many CMs could be prevented by reducing UVR exposure. The aim of this study was to estimate the PAF of CM attributable to UVR exposure and demographic changes in Denmark and Saarland/Germany for the period 1943 to 2036. Material and methods: CM incidence data (ICD-10, C43) for Denmark (1943–2016) and the German Federal State of Saarland (1972–2016) were retrieved from the NORDCAN database and from the Saarland Cancer Registry. The number of CMs attributable to UVR exposure was calculated by comparing contemporary or predicted CM incidence rates with CM rates in Denmark during the years 1943–1946. Results: In Denmark, the proportion of CM cases attributable to UVR exposure increased from around 20\% in 1947–1951 to 96\% in 2012–2016; in the Federal State of Saarland, it increased from 50\% in 1972–1976 to 90\% in 2012–2016. Until 2032–2036, the PAF is expected to rise in Denmark to 97\% and in the Saarland to 92\%. The demographic influence, on the other hand, is rather small. Conclusions: More than 90\% of all CM in Germany and Denmark are attributable to UVR exposure, and in principle, preventable. These findings underline the need for primary prevention strategies, aiming to increase the awareness of melanoma and its risk factors and to promote behavioural changes that decrease sun exposure.",

author = "Ulrike Keim and Sara Gandini and Teresa Amaral and Alexander Katalinic and Bernd Holleczek and Lukas Flatz and Ulrike Leiter and David Whiteman and Claus Garbe",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd",

year = "2021",

month = dec,

doi = "10.1016/j.ejca.2021.09.044",

language = "English",

volume = "159",

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TY - JOUR

T1 - Cutaneous melanoma attributable to UVR exposure in Denmark and Germany

AU - Keim, Ulrike

AU - Gandini, Sara

AU - Amaral, Teresa

AU - Katalinic, Alexander

AU - Holleczek, Bernd

AU - Flatz, Lukas

AU - Leiter, Ulrike

AU - Whiteman, David

AU - Garbe, Claus

PY - 2021/12

Y1 - 2021/12

N2 - Background: Increasing incidence rates of cutaneous melanoma (CM) observed during the last five decades in white populations are largely attributed to increased exposure to solar ultraviolet radiation (UVR), often expressed as population attributable fraction (PAF). Thus, many CMs could be prevented by reducing UVR exposure. The aim of this study was to estimate the PAF of CM attributable to UVR exposure and demographic changes in Denmark and Saarland/Germany for the period 1943 to 2036. Material and methods: CM incidence data (ICD-10, C43) for Denmark (1943–2016) and the German Federal State of Saarland (1972–2016) were retrieved from the NORDCAN database and from the Saarland Cancer Registry. The number of CMs attributable to UVR exposure was calculated by comparing contemporary or predicted CM incidence rates with CM rates in Denmark during the years 1943–1946. Results: In Denmark, the proportion of CM cases attributable to UVR exposure increased from around 20% in 1947–1951 to 96% in 2012–2016; in the Federal State of Saarland, it increased from 50% in 1972–1976 to 90% in 2012–2016. Until 2032–2036, the PAF is expected to rise in Denmark to 97% and in the Saarland to 92%. The demographic influence, on the other hand, is rather small. Conclusions: More than 90% of all CM in Germany and Denmark are attributable to UVR exposure, and in principle, preventable. These findings underline the need for primary prevention strategies, aiming to increase the awareness of melanoma and its risk factors and to promote behavioural changes that decrease sun exposure.

AB - Background: Increasing incidence rates of cutaneous melanoma (CM) observed during the last five decades in white populations are largely attributed to increased exposure to solar ultraviolet radiation (UVR), often expressed as population attributable fraction (PAF). Thus, many CMs could be prevented by reducing UVR exposure. The aim of this study was to estimate the PAF of CM attributable to UVR exposure and demographic changes in Denmark and Saarland/Germany for the period 1943 to 2036. Material and methods: CM incidence data (ICD-10, C43) for Denmark (1943–2016) and the German Federal State of Saarland (1972–2016) were retrieved from the NORDCAN database and from the Saarland Cancer Registry. The number of CMs attributable to UVR exposure was calculated by comparing contemporary or predicted CM incidence rates with CM rates in Denmark during the years 1943–1946. Results: In Denmark, the proportion of CM cases attributable to UVR exposure increased from around 20% in 1947–1951 to 96% in 2012–2016; in the Federal State of Saarland, it increased from 50% in 1972–1976 to 90% in 2012–2016. Until 2032–2036, the PAF is expected to rise in Denmark to 97% and in the Saarland to 92%. The demographic influence, on the other hand, is rather small. Conclusions: More than 90% of all CM in Germany and Denmark are attributable to UVR exposure, and in principle, preventable. These findings underline the need for primary prevention strategies, aiming to increase the awareness of melanoma and its risk factors and to promote behavioural changes that decrease sun exposure.

UR - https://www.scopus.com/pages/publications/85118509223

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DO - 10.1016/j.ejca.2021.09.044

M3 - Journal articles

C2 - 34742161

AN - SCOPUS:85118509223

SN - 0959-8049

VL - 159

SP - 98

EP - 104

JO - European Journal of Cancer

JF - European Journal of Cancer

ER -

Cutaneous melanoma attributable to UVR exposure in Denmark and Germany

Abstract

Funding

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