Clinical and pathological characteristics of melanoma: a population-based study in a French regional population

Although incidence and mortality data are numerous, population-based studies including clinical and pathological characteristics of melanoma are rare.

To describe the characteristics of melanoma in a rural French region during 2004-2008 and to identify differences according to age, gender and geographical areas.

Pathology reports of cutaneous melanomas diagnosed in residents from the Champagne-Ardenne region during 2004-2008 were anonymously collected from pathology laboratories. Demographic, clinical and pathological data were extracted and analysed by experts, including dermatologists, pathologists and epidemiologists.

One hundred and seventy-seven in situ melanomas were diagnosed in 177 patients (female/male ratio : 1.72). Patients with head and neck in situ melanomas were older than patients with melanomas in other locations (72 vs. 54 years; P < 0.0001). Six hundred and sixty-one invasive melanomas were diagnosed (female/male ratio : 1.26), corresponding to an annual incidence rate of 6.3/100,000. Male patients had thicker and more frequently ulcerated tumours. The location widely varied between genders, involving the trunk in 47% of male patients and the lower limb in 48% of female patients. Older patients had thicker and more advanced melanomas, with a more frequent head and neck location. Nodular, acral lentiginous and unclassified melanomas were much thicker than superficial spreading and lentigo maligna melanomas (4.37 vs. 1.33 mm, P < 0.0001). Primary melanomas of advanced stages were more frequent in one of the four districts of the study area. Overall, the mean Breslow thickness (2.02 mm) was much higher than that previously observed in other regions of north-eastern France (1.59 mm).

Information and screening campaigns should particularly target rural areas, males, older people and focus on nodular, acrolentiginous and unclassified subtypes.