Incidence and survival of uveal melanoma in Northern Ireland: how incomplete data can skew results in rare cancers.


Journal

Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986

Informations de publication

Date de publication:
08 2023
Historique:
received: 17 11 2021
accepted: 02 12 2022
revised: 04 11 2022
pmc-release: 01 08 2024
medline: 4 8 2023
pubmed: 10 12 2022
entrez: 9 12 2022
Statut: ppublish

Résumé

The majority of Northern Irish uveal melanoma (UM) patients are diagnosed in Sheffield. This study aims to present incidence and survival outcomes for UM patients from Northern Ireland (NI). Collaborative retrospective study between Sheffield and Northern Ireland Cancer Registry (NICR). For UM cases not on both databases, outcomes and survival rates (via Kaplan-Meier analysis) were compared. Anonymised NICR data were used to calculate whole-population incidence of UM for NI. In total, 161 patients from NI were diagnosed in Sheffield, 90 of which were not registered with NICR at the start of this study. Data-omissions were not consistent across patient groups, leading to significant differences between those patients registered and those not. Registered patients had an all-cause 5-year survival rate of only 68.9% compared to 92.5% of those not registered (p < 0.01) and were >17x more likely to have systemic metastases than those not registered (p < 0·001). Following rectification of data-omissions, the European age-standardised incidence rate of UM for NI was 8·6 per million. This study illustrates the impact of incomplete population-wide data, serving as a real-world lesson in case-identification bias. Rare cancers are at higher risk of omission due to systemic failures as the small numbers involved are not detected by system-wide validation procedures. Following this study, data-transfer agreements between England and NI were actioned, preventing future data-omissions. We present survival and incidence data for UM in NI for the first time, showing the incidence is amongst the highest in Europe, with good survival rates.

Sections du résumé

BACKGROUND
The majority of Northern Irish uveal melanoma (UM) patients are diagnosed in Sheffield. This study aims to present incidence and survival outcomes for UM patients from Northern Ireland (NI).
METHODS
Collaborative retrospective study between Sheffield and Northern Ireland Cancer Registry (NICR). For UM cases not on both databases, outcomes and survival rates (via Kaplan-Meier analysis) were compared. Anonymised NICR data were used to calculate whole-population incidence of UM for NI.
RESULTS
In total, 161 patients from NI were diagnosed in Sheffield, 90 of which were not registered with NICR at the start of this study. Data-omissions were not consistent across patient groups, leading to significant differences between those patients registered and those not. Registered patients had an all-cause 5-year survival rate of only 68.9% compared to 92.5% of those not registered (p < 0.01) and were >17x more likely to have systemic metastases than those not registered (p < 0·001). Following rectification of data-omissions, the European age-standardised incidence rate of UM for NI was 8·6 per million.
CONCLUSIONS
This study illustrates the impact of incomplete population-wide data, serving as a real-world lesson in case-identification bias. Rare cancers are at higher risk of omission due to systemic failures as the small numbers involved are not detected by system-wide validation procedures. Following this study, data-transfer agreements between England and NI were actioned, preventing future data-omissions. We present survival and incidence data for UM in NI for the first time, showing the incidence is amongst the highest in Europe, with good survival rates.

Identifiants

pubmed: 36494430
doi: 10.1038/s41433-022-02352-4
pii: 10.1038/s41433-022-02352-4
pmc: PMC10397225
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2454-2460

Informations de copyright

© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.

Références

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Auteurs

Hibba Quhill (H)

Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield, UK. hibba.quhill@nhs.net.

Joanna M Jefferis (JM)

Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, UK.

Ian G Rennie (IG)

Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield, UK.

Sachin M Salvi (SM)

Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield, UK.

Anna Gavin (A)

Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, Northern Ireland, UK.

Deirdre Fitzpatrick (D)

Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, Northern Ireland, UK.

Gerard Savage (G)

Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, Northern Ireland, UK.

David Curragh (D)

Department of Ophthalmology, Royal Victoria Hospital, Belfast, Northern Ireland, UK.

Paul Rundle (P)

Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield, UK.

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Classifications MeSH