Which medical disciplines diagnose and treat melanoma in Europe in 2019? A survey of experts from melanoma centres in 27 European countries

BACKGROUNDAND OBJECTIVES: Theincidence of melanoma isincreasing. This placessignificant burden onsocieties to provide efficient cancer care.TheEuropean Cancer Organisation recentlypublished theessential requirements for quality melanoma care. The present studyis aimed for the first time to roughly estimate theextentto whichthese requirementshave been metin Europe. MATERIALS AND METHODS: Aweb-based surveyofexperts from melanoma centersin27 European countries was conducted from1February to1August, 2019. Data on diagnostic techniques, surgical and medical treatment, organisation of cancer care and education were collected and correlated with national health and economic indicators andmortality-to-incidence ratio(MIR)as a surrogate for survival. Univariate linear regression analysiswas performed toevaluatethecorrelations.SPSS softwarewas used. Statistical significancewasset atp<0.05. RESULTS: TheMIR was lower in countries withahigh health expenditure per capita and with a highernumbersof general practitioners (GPs) and surgeons per million inhabitants. In these countries,GPs and dermatologistswere involved in melanoma detection; high percentage of dermatologistsuseddermatoscopy and wereinvolved in the follow-up of allmelanoma stages; both medical oncologists and dermato-oncologistsadministeredsystemic treatments and patients hadbetter access to sentinel lymph nodebiopsy and were treated within multidisciplinary tumour boards CONCLUSION: Based on these first estimates, thegreater involvement of GPs in melanoma detection;thegreater involvement of highly trained dermatologists in dermatoscopy, dermatosurgery, follow-up andthesystemic treatment of melanoma;andthe provision of ongoingdermato-oncology training for pathologists, surgeons, dermatologists and medical oncologists are necessary toprovide anoptimal melanoma care pathway. A comprehensive analysis of the melanoma care pathway based on clinical melanoma registries, will be needed to more accurately evaluate these first insights.