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Rev Colomb Cancerol. 2013;17(3):91-92
Revista Colombiana
de
Cancerología
VOLUMEN 17
de
NÚMERO 3
SEPTIEMBRE / 2013
Editorial
Melanomas in Colombia; a diferent reality
Esther de Vries
ISSN 0123-9015 Tarifa Postal Reducida No 2010-392; vence: 31 de diciembre 2013
Revista Colombiana
Título: No te comtamines
Autor: Nelson Hernández Chitiva
Concurso de fotografía “No fumar es la actitud”
Instituto Nacional de Cancerología ESE
Todos los derechos reservados © 2005 - 2011
Cancerología
Originales
Barreras para la implementación de la prueba
ADN-VPH como técnica de tamización
primaria para cáncer de cuello uterino
en un área demostrativa en Colombia
Carolina Wiesner, Lina Rincón, Óscar Gamboa,
Marion Piñeros, Mauricio González, Natascha Ortiz,
Gustavo Hernández, Mónica Molano y Ruth Robles
Evaluation of the immune response
to human papillomavirus types 16, 18, 31,
45 and 58 in a group of Colombian women
vaccinated with the quadrivalent vaccine
Alba Cómbita, Diego Duarte, Josefa Rodríguez,
Mónica Molano, Lina Martínez, Pilar Romero,
Lina Trujillo, Mauricio González, Joaquín Luna,
Natascha Ortiz, Gustavo Hernández,
Pierre Coursaget, Antoine Touzé
Características del melanoma cutáneo
primario en el Instituto Nacional
de Cancerología 2006-2010
Flavia Pozzobon, Álvaro Acosta,
Alexander Carreño y Eduardo Fierro
Reporte de caso
Tumor pilar proliferante maligno
en cuero cabelludo
Adisson Muñoz, Francisco Lama, Xavier Rueda,
Álvaro Acosta y Mariam Rolon
Imágenes oncológicas
I-131 SPECT/CT en cáncer diferenciado
de tiroides
Augusto Llamas-Olier y Enrique Cadena
Linfoma primario de sistema nervioso central,
imagen con FDG-PET/CT
Alejandro Martí Samper
www.elsevier.es/cancerologia
Publicación científica y oficial del Instituto Nacional de Cancerología
EDITORIAL
Melanomas in Colombia; a different reality
Melanomas en Colombia; una realidad diferente
In contrast to other parts of the world, melanomas are not
among the most frequently diagnosed cancers in Colombia
or South America, which is probably the reason why they are
not studied as intensely in this continent as in other parts of
the world. However, the few studies that have investigated
time trends in cancer incidence and/or mortality in the
region have observed steady increases in trends over
the past decades.
In predominantly Caucasian populations, melanomas are
amongst the most frequently diagnosed tumors, exhibiting
a very sharp and continuous increase in incidence since
the 1950s. Fortunately, in these high incidence areas
of the world, melanomas are increasingly being diagnosed
earlier, reducing the case-fatality substantially. Five-year
relative survival rates of all melanomas are around 90%
in northwestern Europe, the USA and Australia. Moreover,
new treatment options were recently introduced, thus also
improving prognosis for advanced stage melanomas.
In Colombia, melanoma is still a rare tumor, being
diagnosed in approximately 4.5/100 000 individuals per year.
Unfortunately, its case-fatality is relatively high, making
melanoma a much more fatal cancer here than in the highincidence areas of the world.
Although melanomas are often considered to be one
entity of cancer, their characteristics, prognosis, and —probably also— risk factors differ substantially by histological
subtype, as well as by stage at diagnosis. In this issue of
R EVIS TA C OLOMBIANA DE C ANCEROLOGÍA , the databases of the
Instituto Nacional de Cancerología (INC) were analyzed to
describe the characteristics of the melanomas diagnosed
and treated in this institution between 2006 and 2010. The
findings of this study show very interesting patterns, which
differ substantially from the patterns observed in the highincidence areas of the world. Although these are findings
from one institution, which may represent a selective group
of patients, they represent a large group of patients from
an important hospital in terms of melanoma patients
(115 patients treated annually). Assuming that these patterns
represent the general pattern of melanomas diagnosed
at a national level, it provides possible explanations for
the relatively high case-fatality rate of melanomas in the
country: many relatively aggressive subtypes and more than
50% of patients presenting advanced stage melanomas at
diagnosis.
Whereas acral melanomas are very rarely diagnosed
in Caucasian populations, they represent around 45% of
all melanomas diagnosed at the INC. This is not a new
finding; it is well known that acral melanomas are more
frequent in non-Caucasian populations, particularly so
for Asians. However, relative frequencies have very rarely
been described, and even less for the South American continent. Acral melanomas constitute a very interesting, but
understudied, subtype of melanomas, probably because
of their rare frequency in high-incidence countries. The
risk factors for acral melanomas are unknown, they are
thought to be unrelated to ultraviolet radiation, unlike other
melanoma subtypes.
Probably because of the high proportion of acral melanomas, the prevailing body sites at which melanomas occur
also differ greatly from those observed in high-incidence
countries. Whereas the great majority of melanomas in
high-incidence geographical areas are mainly found on the
trunk and arms of men and trunk and legs of women, in this
series of patients the predominant localizations were the
head, neck and feet in both genders.
The findings of this publication adds important information to the profile on the melanoma epidemiology in
Latin America and form a good base from which to illustrate
the need for further investigations into risk factors and
prevention possibilities, prognosis and treatment options. It
particularly highlights the high frequency of acral lentiginous
melanomas in this part of the world, which is interesting
0123-9015/$ - see front matter © 2013 Instituto Nacional de Cancerología. Publicado por Elsevier España, S.L. Todos los derechos reservados.
Documento descargado de http://www.elsevier.es el 18/11/2016. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato.
92
information for those investigating biological pathways and
possibilities for new treatment of this particular subtype of
melanoma. The finding of a very large proportion of late
diagnoses illustrates the need for better public awareness of the need to consult a physician when there are
suspicious, changing lesions on the skin. Primary and secondary prevention messages should probably be adapted to
E. de Vries
the different ‘melanoma reality’ in this part of the world,
with different presentation of melanomas, different body
sites and most likely very different risk factors.
Esther de Vries
Instituto Nacional de Cancerología, Bogotá, Colombia
E-mail: [email protected]