• Assessing the feasibility and validity of the Toronto Childhood Cancer Stage Guidelines: a population-based registry study.

      Aitken, J; Youlden, D; Moore, A; Baade, P; Ward, L; Thursfield, V; Valery, P; Green, Adèle C; Gupta, S; Frazier, A; et al. (2018-03)
      Cancer stage at diagnosis is crucial for assessing global efforts to increase awareness of childhood cancer and improve outcomes. However, consistent information on childhood cancer stage is absent from population cancer registries worldwide. The Toronto Childhood Cancer Stage Guidelines, compiled through an international consensus process, were designed to provide a standard framework for collection of information on stage at diagnosis of childhood cancers. We aimed to assess the feasibility of implementing the Toronto Guidelines within a national population cancer registry.
    • Clinicopathological factors associated with death from thin (</=1.00mm) melanoma

      Claeson, M; Baade, P; Brown, S; Soyer, HP; Smithers, BM; Green, Adèle C; Whiteman, DC; Khosrotehrani, K; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia (2019)
    • Clinicopathological factors associated with death from thin (<= 1 mm) melanoma

      Claeson, M; Baade, P; Brown, S; Soyer, P; Smithers, M; Green, Adèle C; Whiteman, D; Khosrotehrani, K; Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia (2019)
    • Comparison of melanoma incidence and trends among youth under 25 years in Australia and England, 1990-2010.

      Wallingford, S; Iannacone, M; Youlden, D; Baade, P; Ives, A; Verne, J; Aitken, J; Green, Adèle C; Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom (2015-05-08)
      White populations in Australia and England share many genetic and phenotypic characteristics due to common ancestry, but Australians experience far higher rates of melanoma due to higher ambient ultraviolet radiation (UVR) levels. To gain insight into the role of UVR on melanoma development early in life, we used national cancer registration data and compared recent incidence rates and long-term trends of primary invasive cutaneous melanoma in Australian and English youth aged 0-24 years diagnosed 1990-2010. Incidence rates and standardized rate ratios (SRRs) with 95% confidence intervals (CIs) for 2006-2010 were calculated and incidence trends across the whole period were examined using JoinPoint regression. In Australian youth, overall melanoma incidence was double that in English youth (2.2 and 1.1 per 100,000, respectively). While melanoma rates were similarly rare among children <10 years in both countries, in subsequent 5-year age groups, incidence was significantly higher in Australia compared to England. Melanoma incidence among 15-24 year olds significantly increased by more than 2% per year in both sexes in England. However, after an initial non-significant increase, Australian rates for this older age group significantly decreased by 6.0% (95% CI, -8.2 to -3.8) per year in females from 1997 and decreased by 12.4% (95% CI, -20.3 to -3.8) per year in males from 2004. Long-standing primary prevention strategies targeted at curbing UVR exposure appear to have been effective in mitigating incidence trends in Australian youth, but decreases in incidence in English youth are yet to be observed.
    • Diagnosis of an additional in situ melanoma does not influence survival for patients with a single invasive melanoma: A registry-based follow-up study.

      Youlden, D; Khosrotehrani, K; Green, Adèle C; Soyer, H; Kimlin, M; Youl, P; Aitken, J; Baade, P; Cancer Council Queensland, Brisbane, Queensland, Australia (2016-02)
      Using a large (N= 25 493) population-based cohort from Queensland, Australia, we compared melanoma survival among cases with a single invasive melanoma only against those who also had a diagnosis of a single in situ melanoma. After adjustment for sex, age, body site, clinicopathological subtype, thickness and ulceration, it was found that there was no difference (P = 0.99) in 10-year melanoma-specific mortality following a diagnosis of an invasive lesion, whether or not an in situ melanoma was also present. We conclude that in situ melanomas do not alter the prognosis of an invasive melanoma.
    • In response to: immigration is the most likely reason for the generational change in melanoma incidence in Queensland, Australia.

      Aitken, J; Youlden, D; Baade, P; Soyer, H; Green, Adèle C; Smithers, B; Cancer Council Queensland, Brisbane, QLD, Australia (2018-02-28)
    • Melanoma survival is superior in females across all tumour stages but is influenced by age.

      Khosrotehrani, K; Dasgupta, P; Byrom, L; Youlden, D; Baade, P; Green, Adèle C; The University of Queensland Centre for Clinical Research, Royal Brisbane Hospital Building 71/918, Herston, Brisbane, QLD, 4029, Australia. (2015-10)
      Among patients with invasive melanoma, females are known to have higher survival than males globally. However, this survival advantage has not been explored in thin melanomas, the most common form of the disease. In addition, it is unclear if this advantage is true across all age groups. We aimed to compare melanoma survival between males and females by clinical stage and within age groups. Melanomas from 1995 to 2008 were extracted from the Queensland Cancer Registry and the Surveillance, Epidemiology, and End Results (SEER) Program, and melanoma-specific deaths were ascertained up to 2011. Flexible parametric survival models compared survival between groups. The Queensland cohort of 28,979 patients experienced 1712 melanoma deaths and the SEER cohort of 57,402 patients included 6929 melanoma deaths. Survival rates were in favour of females across nearly all tumour stages, including thin invasive tumours in both cohorts after adjusting for demographic and clinical factors [odds ratio (OR) death female:male for stage I melanoma = 0.64 in Queensland; and OR = 0.79 in the US, both P < 0.001]. The sex influence on survival interacted with age categories. In particular, the survival advantage was inconsistent in females with stage I melanoma aged under 60. Females with melanoma have a survival advantage over males including in stage I melanomas. However, this advantage is dependent on age at diagnosis, suggesting an underlying biological mechanism influenced by age that exists from the very early stages of the disease.
    • Prognostic importance of a second invasive primary melanoma according to tumor stage.

      Youlden, D; Baade, P; Aitken, J; Green, Adèle C; Khosrotehrani, K; Cancer Council Queensland, Brisbane, Queensland, Australia (2017-08-03)
      It is well known that a considerable proportion of the Caucasian population in many countries are diagnosed with multiple melanomas over time(1) . Despite this, most analyses of melanoma survival, including that of the American Joint Committee on Cancer (AJCC), consider only one tumor for every patient and disregard the potential effect of multiple melanomas on outcomes and this is reflected in the lack of specific management guidelines for patients with multiple melanomas beyond those dictated by the clinicopathological features of each tumour(2-4) . Recently we and others have shown that patients with multiple primary invasive melanomas have an increased risk of melanoma death compared to patients with a single melanoma(5,6) . This article is protected by copyright. All rights reserved.
    • Response to commentary 'utility and limitations of large population-based data for skin cancer outcomes'.

      Youlden, D; Baade, P; Soyer, H; Youl, P; Kimlin, M; Aitken, J; Green, Adèle C; Khosrotehrani, K; Cancer Council Queensland, Brisbane, Queensland, Australia. (2016-12-12)
    • Ten-year survival after multiple invasive melanomas is worse than after a single melanoma: a population-based study.

      Youlden, D; Baade, P; Soyer, H; Youl, P; Kimlin, M; Aitken, J; Green, Adèle C; Khosrotehrani, K; Cancer Council Queensland, Brisbane, Queensland, AustraliaCancer Council Queensland, Brisbane, Queensland, Australia (2016-03-23)
      The prognosis of melanoma patients who are diagnosed with multiple primary lesions remains controversial. We used a large, population-based cohort to re-examine this issue, applying a delayed entry methodology to avoid survival bias. Of 32,238 eligible patients diagnosed between 1995 and 2008, 29,908 (93%) had a single invasive melanoma, 2,075 (6%) had two and 255 (1%) had three. Allowing for differences in entry time, 10-year cause-specific survival for these three groups was 89% (95% CI = 88%-90%), 83% (95% CI = 80%-86%) and 67% (95% CI = 54%-81%), respectively. After adjustment for key prognostic factors, the hazard ratio (HR) of death within 10 years from melanoma was two times higher for those with two melanomas (HR = 2.01, 95% CI = 1.57-2.59; p<0.001) and nearly three times higher when three melanomas were diagnosed (HR = 2.91, 95% CI = 1.64-5.18; p<0.001) compared to people with a single melanoma. Melanoma-specific mortality remained elevated after adjusting for maximum thickness or ulceration of any melanoma regardless of the index tumor. After appropriately accounting for the interval between diagnosis of the first and subsequent melanomas, patients with multiple invasive melanomas have significantly poorer survival than patients with a single invasive melanoma.
    • Trends in melanoma mortality in the population groups of South Africa

      Wright, CY; Kapwata, T; Singh, E; Green, Adèle C; Baade, P; Kellett, P; Norval, M; Environment and Health Research Unit, South African Medical Research Council, Pretoria, South Africa (2019)
      The incidence of cutaneous melanoma (CM) is increasing in countries around the world. However, little is known about melanoma trends in African countries by population group. We studied CM mortality in South Africa from 1997 to 2014 to partly address this knowledge gap. Unit record mortality data for all South Africans who died from CM (n = 8,537) were obtained from Statistics South Africa. Join-point regression models were used to assess whether there was a statistically significant change in the direction and/or magnitude of the annual trends in CM mortality. A significant increasing trend of 11% per year was observed in age-adjusted mortality rates in men between 2000 and 2005 (p < 0.01), rising from 2 to 3 per 100,000. There was also a statistically significant increase of 180% per year among White South Africans from 1997 to 1999 (p < 0.05) and of 3% from 1999 to 2014 (p < 0.01). These results may be used to inform CM awareness campaigns and will motivate efforts to improve the collection and analysis of relevant statistics regarding the present burden of CM in South Africa.