Letters to the Editor
In Reply
We have two comments. Cancer registration in Germany, with regional data reaching far back into the past, is at a high level by international standards. This is supported by hundreds of high-ranking original research papers that are based on German cancer registry data (1). Cancer registry data are, however, only as good as what is reported by doctors. Especially missing data regarding tumor stage in melanoma come as a surprise since for almost all notified tumors, pathology data are available.
The criticism regarding changing TNM versions over time has been taken into account appropriately and as comprehensively as possible. However, this is of subordinate importance due to the reclassification of the TNM to the UICC stage and the use of statistical methods. We would also like to counter that persons with early-stage tumors at the initial diagnosis can also benefit from novel treatments—namely, when the disease progresses. Further, the presented results are largely free from the effects of skin cancer screening. Possible screening effects were corrected for by adjusting for stage and were therefore eliminated.
Overall the quality of the data is good enough to allow an assessment of therapeutic effects in melanoma, using current statistical-epidemiological methods. The evaluation of the results should always be based on the rules of evidence-based medicine, to which the authors attach great importance (2). It is indisputable that survival from melanoma has improved significantly over the past 20 years; even if the contribution of the novel therapies cannot be proven due to the non-randomized controlled study design, it is to be assumed. This is currently the best evidence on this question.
DOI: 10.3238/arztebl.m2024.0066
On behalf of the authors
Dr. rer. hum. biol. Nora Eisemann
Institut für Sozialmedizin und Epidemiologie
Universitätsklinikum Schleswig-Holstein, Lübeck
Nora. Eisemann@uksh.de
Conflict of interest statement
The authors of all contributions declare that no conflict of interest exists.
| 1. | Katalinic A, Pritzkuleit R, Kraywinkel K: Forschung mit Krebsregister—was geht, was (noch) nicht? Onkologie 2023; 30: 280–8 CrossRef |
| 2. | Eisemann N, Schumann L, Baltus H, Labohm L, Kraywinkel K, Katalinic A: Longer survival from melanoma in Germany: A registry-based time series study. Dtsch Arztebl Int 2024; 121: 45–51 VOLLTEXT |
