Impactos sócioeconômicos e ambientais do melanoma cutâneo: estudo epidemiológico em Campina Grande.

Abstract

Melanoma is the skin cancer with the highest mortality rate, despite accounting for 5% of the total number of cases. Its incidence has been progressively increasing in recent decades worldwide, but the true magnitude of the problem is not known, especially in our region. Descriptive studies of primary melanoma in various locations are important and necessary to improve preventive measures for this pathology and to assist public health policies for prevention, diagnosis, and better intervention, reducing the impact of the disease on a social level. With the aim of evaluating the epidemiological profile of patients with histopathological diagnosis of melanoma from the city of Campina Grande, Paraíba, between 1996 and 2021; a cross-sectional epidemiological study of a retrospective nature was conducted, with quantitative and qualitative analysis of the data. The studied variables were: gender, age, anatomical location of the tumor, histological type, level of invasion (Clark), tumor thickness (Breslow), presence of inflammatory infiltrate, and ulceration. The data were analyzed using the R program, presented descriptively, and various tests were used based on the absolute and percentage indices found. Of the 1060 registered exams with a positive diagnosis for melanoma, 642 cases of primary cutaneous melanoma were found. The majority (72%) of the cases were considered invasive, with a similar proportion between men and women. Superficial spreading melanoma was the most frequent subtype, found in 70% of in situ tumors and 41% of invasive ones. In situ tumors are more common in women, reflecting a better prognosis, which can be justified as a higher standard of primary prevention associated with the female gender. Invasive tumors mostly presented with a Breslow index greater than 4mm, being more common in the elderly. Ulceration was present in 75% of cases. Both are findings of worse prognosis. Regarding the Clark level, in this study, the majority of cases (85%) were between levels II and IV. In terms of location, most (93%) of the primary cutaneous melanomas were found in areas of photoexposure, whether intermittent (75%) or continuous (18%). The number of melanoma cases has been increasing each year over the past 25 years. Most skin tumors are located in photoexposed areas, thick and ulcerated, which means late diagnosis and worse prognosis. In light of the growing number of new cases, understanding the behavior of melanoma in this region allows for better planning of public policies.