High regional mortality due to malignant melanoma in Eastern Finland may be explained by the increase in aggressive melanoma types

Background A regional skin cancer prevention program in Eastern Finland revealed a relatively high age-standardized mortality due to malignant melanoma during 2013–2017. An explanation for this is needed. Purpose To analyse the 543 melanoma samples in 524 subjects collected during 2000–2013 at Kuopio University Hospital and reposited in the Biobank of Eastern Finland. A focus was directed to factors related to metastasis. Methods The samples were analysed anonymously by examining the histopathological report, referral text and the list of diagnoses. A possible state of immunosuppression was evaluated. Results The mean age at the diagnosis of malignant melanoma (MM), lentigo maligna (LM) and melanoma in situ was relatively high, i.e., 66.2, 72.1 and 63.3, respectively. Especially the MM type increased markedly during 2000–2013. In further analyses of a representative cohort of 337 samples, the proportion of nodular melanoma and LM/LMM melanoma was relatively high, 35.6 and 22.0%, respectively, but that from superficial spreading melanoma relatively low (33.8%). Metastasis correlated with immunosuppression, male gender, Clark level, Breslow thickness, ulceration, mitosis count, invasion into vessels and/or perineural area, microsatellites, melanoma subtype, body site, recidivism, and the absence of dysplastic nevus cells. Conclusion The marked increase in aggressive melanomas with associated metastasis, and the relatively high age at diagnosis, can partially explain the mortality.

The knowledge of young women about cervical cancer

Introduction. Women in Poland suffer from and die of cervical cancer more often than women from other European countries. The reason for this phenomenon is the fact that women in Poland are reluctant to perform Pap smear tests. Reluctance to undergo a Pap smear is due to low awareness of its course. Numerous studies show that women do not know much about the course of illness, risk factors and prevention of cervical cancer. In its prevention, health behaviors are important from the moment of sexual initiation, so it is important that young women have sufficient knowledge about it. Aim. Determining the state of knowledge of the respondents, comparing social awareness to previous research and proposing new preventive solutions. Material and methods. An anonymous questionnaire survey was conducted in electronic form among women aged 16-25 from all over Poland. The study was conducted using a proprietary questionnaire (Google form) completed online. The questionnaire contained closed questions verifying the knowledge of the topic under study and personal information. The following computer programs were used for statistical analysis of data: Statistica and Microsoft Excel. Results. Almost half of the surveyed women believes that the use of oral hormonal contraception does not increase the risk of developing cervical cancer. One in ten women does not know about the existence of an HPV vaccine. Nearly one third of the respondents do not see a gynecologist at all. Nearly two-thirds of women do not perform a Pap smear. Conclusions. The surveyed women have some knowledge concerning cervical prophylaxis, but they rarely use it in practice. However, the knowledge of women about the symptoms and risk factors of cervical cancer is small. Too few women know about the existence of a cervical cancer prevention program in Poland.