{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:15:28Z","timestamp":1790928928802,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,1,3]],"date-time":"2005-01-03T00:00:00Z","timestamp":1104710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2005,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Recent studies revealed that incidence rates of cutaneous melanoma (CM) were leveling off predominantly among younger people and patterns suggested birth\u2010cohort effects. The current study analyzed the development of prognostic factors and survival in incident CM over 25 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>All 45,483 patients with incident CM diagnosed between 1976 and 2000 recorded by the German Central Malignant Melanoma Registry were considered. Linear and logistic regression analyses were used to judge time trends. Trends of survival rates were tested with the multivariate Cox model.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Median tumor thickness decreased from 1.81 mm in 1976 to 0.53 mm in 2000 (<jats:italic>P<\/jats:italic> &lt; 0.0001). The percentages of in situ and level II CM increased, respectively (<jats:italic>P<\/jats:italic> &lt; 0.0001). The percentage of ulcerated CM decreased (<jats:italic>P<\/jats:italic> &lt; 0.0001). The percentage of superficial spreading melanoma increased, whereas the percentage of nodular melanoma decreased (<jats:italic>P<\/jats:italic> &lt; 0.0001). These time trends were all significant in the strata of gender, however, male patients presented in general with more advanced disease. Between 1976 and 2000, the average patient got older (<jats:italic>P<\/jats:italic> &lt; 0.0001). The percentage of patients diagnosed with the primary tumor alone increased (<jats:italic>P<\/jats:italic> &lt; 0.0001). Across the 25 years of observation, adjusted survival rates did not increase for females (<jats:italic>P<\/jats:italic> = 0.1561) but they increased for males (<jats:italic>P<\/jats:italic> &lt; 0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The data demonstrated a strong trend towards prognostically more favorable CM most likely due to earlier diagnosis. Men and older people should be the focus of health promotion activities as they presented with more advanced disease. Cancer 2005. \u00a9 2005 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.20816","type":"journal-article","created":{"date-parts":[[2005,1,3]],"date-time":"2005-01-03T15:44:51Z","timestamp":1104767091000},"page":"616-624","source":"Crossref","is-referenced-by-count":81,"title":["Development of prognostic factors and survival in cutaneous melanoma over 25 years"],"prefix":"10.1002","volume":"103","author":[{"given":"Petra G.","family":"Buettner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Leiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas K.","family":"Eigentler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Garbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,1,20]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"27","volume-title":"Cutaneous melanoma: clinical management and treatment results worldwide","author":"Grin\u2010Jorgensen CM","year":"1992"},{"key":"e_1_2_5_3_2","first-page":"701","article-title":"Cancer incidence and mortality trends among whites in the United States, 1947\u201084","volume":"79","author":"Devesa SS","year":"1987","journal-title":"J Natl Cancer Inst."},{"key":"e_1_2_5_4_2","first-page":"1","article-title":"Trends in the cancer incidence in the Nordic countries. A collaborative study of the five Nordic Cancer Registries","volume":"288","author":"Hakulinen T","year":"1986","journal-title":"Acta Pathol Microbiol Immunol Scand"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11360"},{"key":"e_1_2_5_6_2","first-page":"29","article-title":"Changing trends in melanoma incidence and mortality","volume":"10","author":"Gaudette LA","year":"1998","journal-title":"Health Rep."},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008964621225"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00053149"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(99)70562-1"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/29.3.416"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.1203"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19990331)81:1<62::AID-IJC12>3.0.CO;2-2"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.1999.1243"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(03)00002-4"},{"key":"e_1_2_5_15_2","first-page":"99","article-title":"Cancer registration in Germany: current status, perspectives and trends in cancer incidence 1973\u201093","volume":"5","author":"Schuz J","year":"2000","journal-title":"J Epidemiol Biostat."},{"key":"e_1_2_5_16_2","unstructured":"The network of German population\u2010based registries. Available from URL:http:\/\/www.rki.de\/GBE\/KREBS\/BROSCHUERE2002\/BROSCHUERE2002.HTM[accessed June 30 2004]."},{"key":"e_1_2_5_17_2","first-page":"165","volume-title":"Cutaneous melanoma: clinical management and treatment results worldwide","author":"Balch CM","year":"1992"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19930601)71:11<3737::AID-CNCR2820711143>3.0.CO;2-7"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19950515)75:10<2484::AID-CNCR2820751014>3.0.CO;2-U"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.16.3622"},{"key":"e_1_2_5_21_2","first-page":"321","article-title":"A ten\u2010year analysis of demographic trends for cutaneous melanoma: analysis of 2501 cases treated at the University Department of Dermatology in Vienna (1990\u20101999)","volume":"113","author":"Kittler H","year":"2001","journal-title":"Wien Klin Wochenschr."},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1994.388"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19981029)78:3<315::AID-IJC10>3.0.CO;2-5"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/028418602753669508"},{"key":"e_1_2_5_25_2","first-page":"40","volume-title":"Cutaneous melanoma: clinical management and treatment results worldwide","author":"Balch CM","year":"1992"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.135.3.275"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.9.678"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000915)89:6<1269::AID-CNCR11>3.0.CO;2-C"},{"key":"e_1_2_5_29_2","first-page":"424","article-title":"Melanoma incidence and trends in the Nelson\u2010Marlborough area of New Zealand","volume":"105","author":"Hursthouse MW","year":"1992","journal-title":"N Z Med J."},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1980.tb134628.x"},{"key":"e_1_2_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(02)00104-1"},{"key":"e_1_2_5_32_2","first-page":"537","article-title":"Public education in recognizing melanoma","volume":"64","author":"Illig L","year":"1989","journal-title":"Z Hautkr."},{"key":"e_1_2_5_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00211432"},{"key":"e_1_2_5_34_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.51.6.698"},{"key":"e_1_2_5_35_2","first-page":"391","article-title":"Prevention of melanoma by sun protective measures in childhood. Temporal changes in awareness of parents","volume":"48","author":"Kolmel KF","year":"1997","journal-title":"Hautarzt."},{"key":"e_1_2_5_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7116.1117"},{"key":"e_1_2_5_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008469-200110000-00004"},{"key":"e_1_2_5_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/84.18.1427"},{"key":"e_1_2_5_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/24.5.897"},{"key":"e_1_2_5_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19830815)52:4<755::AID-CNCR2820520433>3.0.CO;2-Q"},{"key":"e_1_2_5_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)91539-K"},{"key":"e_1_2_5_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19811115)48:10<2329::AID-CNCR2820481032>3.0.CO;2-O"},{"key":"e_1_2_5_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1988.tb03588.x"},{"key":"e_1_2_5_44_2","first-page":"12","volume-title":"Cutaneous melanoma: clinical management and treatment results worldwide","author":"Armstrong BK","year":"1992"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.20816","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.20816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T12:33:54Z","timestamp":1760272434000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.20816"}},"subtitle":["An analysis of the Central Malignant Melanoma Registry of the German Dermatological Society"],"short-title":[],"issued":{"date-parts":[[2005,1,20]]},"references-count":43,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2005,2]]}},"alternative-id":["10.1002\/cncr.20816"],"URL":"https:\/\/doi.org\/10.1002\/cncr.20816","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,1,20]]}}}