Temporal and spatial melanoma trends in Austria: an ecological study

Area of Science:

• Dermatology
• Epidemiology
• Environmental Health

Background:

• Solar ultraviolet radiation (UVR) levels are influenced by latitude and altitude, with observed increases in recent decades.
• Exposure to UVR is a significant risk factor for developing melanoma, a serious form of skin cancer.
• Geographical factors like altitude may impact UVR exposure and subsequent melanoma risk.

Purpose of the Study:

• To investigate the association between altitude of residence and time of diagnosis with melanoma incidence and mortality in Austria.
• To explore potential explanations for discrepancies between melanoma incidence and mortality rates in relation to altitude.

Main Methods:

• An ecological study design was employed, analyzing Austrian melanoma incidence (1990-2010) and mortality (1970-2011) data by district and year.
• Statistical analysis was performed to assess the correlation between altitude, year of diagnosis, and melanoma rates.
• Incidence and mortality data were compared across different altitudes and between urban and rural districts.

Main Results:

• Melanoma incidence rates showed a positive correlation with altitude (approximately 2% per 10m increase) and year (approximately 2% increase per year).
• Urban districts exhibited approximately 50% higher melanoma incidence rates compared to rural districts.
• Conversely, melanoma mortality rates decreased with increasing altitude (0.4% per 10m for males, 0.7% per 10m for females).

Conclusions:

• Higher altitudes are associated with increased melanoma incidence but decreased mortality in Austria.
• The discrepancy suggests earlier tumor stage diagnosis at higher altitudes, possibly due to increased patient awareness or improved diagnostics.
• Potential protective factors at higher altitudes, such as enhanced vitamin D synthesis from sunlight, warrant further investigation.