Differences in the diagnosis of primary cutaneous melanoma in the public and private healthcare systems in Joinville, Santa Catarina State, Brazil

Steglich, Raquel Bissacotti; Cardoso, Silvana; Gaertner, Maria Helena da Costa Naumann; Coelho, Karina Munhoz de Paula Alves; Cestari, Tania Ferreira; Franco, Selma Cristina

doi:10.1590/abd1806-4841.20185767

Raquel Bissacotti Steglich Mailing address: Raquel Bissacotti Steglich. E-mail: raquelsteglich@yahoo.com.br

Dermaclinic Clínica de Dermatologia de Joinville, Joinville (SC), Brazil.

http://orcid.org/0000-0001-6550-3715

Silvana Cardoso

Medical student, Universidade da Região de Joinville, Joinville (SC), Brazil.

http://orcid.org/0000-0002-0025-9149

Maria Helena da Costa Naumann Gaertner

Medical student, Universidade da Região de Joinville, Joinville (SC), Brazil.

http://orcid.org/0000-0002-8970-3604

Karina Munhoz de Paula Alves Coelho

Department of Medicine, Universidade da Região de Joinville, Joinville (SC), Brazil.

http://orcid.org/0000-0002-4743-8742

Tania Ferreira Cestari

Dermatology Service, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brazil.

http://orcid.org/0000-0003-3001-0202

Selma Cristina Franco

Department of Medicine, Universidade da Região de Joinville, Joinville (SC), Brazil.

http://orcid.org/0000-0002-0323-2988

Mailing address: Raquel Bissacotti Steglich. E-mail: raquelsteglich@yahoo.com.br

Conflict of Interest: None.

AUTHORS CONTRIBUTION

Raquel Bissacotti Steglich

ORCID 0000-0001-6550-3715

Statistical analysis; Approval of the final version of the manuscript; Conception and planning of the study; Elaboration and writing of the manuscript; Obtaining, analyzing and interpreting the data; Effective participation in research orientation; Intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied; Critical review of the literature; Critical review of the manuscript.

Silvana Cardoso

ORCID 0000-0002-0025-9149

Elaboration and writing of the manuscript; Obtaining, analyzing and interpreting the data

Maria Helena da Costa Naumann Gaertner

ORCID 0000-0002-8970-3604

Elaboration and writing of the manuscript; Obtaining, analyzing and interpreting the data

Karina Munhoz de Paula Alves Coelho

ORCID 0000-0002-4743-8742

Approval of the final version of the manuscript; Obtaining, analyzing and interpreting the data; Critical review of the manuscript

Tania Ferreira Cestari

ORCID 0000-0003-3001-0202

Approval of the final version of the manuscript; Conception and planning of the study; Elaboration and writing of the manuscript; Obtaining, analyzing and interpreting the data; Effective participation in research orientation; Intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied; Critical review of the literature; Critical review of the manuscript

Selma Cristina Franco

ORCID 0000-0002-0323-2988

Statistical analysis; Approval of the final version of the manuscript; Conception and planning of the study; Elaboration and writing of the manuscript; Obtaining, analyzing and interpreting the data; Effective participation in research orientation; Intellectual participation in propaedeutic and/or therapeutic conduct of the cases studied; Critical review of the literature; Critical review of the manuscript

Type of healthcare system		Private		Public		p-value^* * Chi-square test.
Type of healthcare system	N	N	(%)	N	(%)
Total	893	526	(58.9)	367	(41.1)
Gender						0.264
Female	507	290	(57.2)	217	(42.8)
Male	386	236	(61.1)	150	(38.9)
Age bracket (years)						< 0.001
Young(0-59)	546	352	(64.5)	194	(35.5)
Old(≥60)	347	174	(50.1)	173	(49.9)
Multiple CMs						0.999
Yes	127	52	(40.9)	75	(59.0)
No	766	474	(61.9)	292	(38.1)

Histological type		Private		Public
Histological type	N	N	(%)	N	(%)
LMM	91	57	(10.9)	34	(9.4)
DM	5	2	(0.4)	3	(0.8)
ALM	10	5	(1.0)	5	(1.4)
NMM	9	6	(1.1)	3	(0.8)
NM	168	63	(12.1)	105	(28.9)^* * adjusted residuals analysis;
Melanoma,NOS	86	46	(8.8)	40	(11.0)
SSM	516	343	(65.7)^* * adjusted residuals analysis;	173	(47.7)
Total^ missing data. LMM = lentigo maligna melanoma; DM = desmoplastic melanoma; ALM = acral lentiginous melanoma; NMM = nevoid malignant melanoma; NM = nodular melanoma; SSM = superficial spreading melanoma; NOS = not otherwise specified.	885	522	(100.0)	363	(100.0)

Histological type		Private		Public
Histological type	n	n	(%)	n	(%)
*In situ*	203	138	(27.1)^* * adjusted residuals analysis;	65	(18.6)
T1	369	250	(49.0)^* * adjusted residuals analysis;	119	(34.1)
T2	112	62	(12.1)	50	(14.3)
T3	81	28	(5.5)	53	(15.2)^* * adjusted residuals analysis;
T4	94	32	(6.3)	62	(17.8)^* * adjusted residuals analysis;
Total^ missing data	859	510	(100.0)	349	(100.0)

Variables	OR	95%CI	p-value^* * p-value, logistic regression
Age
< 60 years	1.00
≥60years	1.64	1.22-2.20	0.001
Histological level
In situ	1.00
T1	1.05	0.72-1.52	0.800
T2	1.75	1.08-2.82	0.022
T3	3.79	2.19-6.56	<0.001
T4	3.80	2.25-6.41	<0.001

[1] Mailing address: Raquel Bissacotti Steglich. E-mail: raquelsteglich@yahoo.com.br

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Differences in the diagnosis of primary cutaneous melanoma in the public and private healthcare systems in Joinville, Santa Catarina State, Brazil^* * Work conducted at Universidade da Região de Joinville, Joinville (SC), Brazil.

Abstract:

Background:

Objectives:

Methods:

Results:

Study limitations:

Conclusions:

Brasil

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Differences in the diagnosis of primary cutaneous melanoma in the public and private healthcare systems in Joinville, Santa Catarina State, Brazil* * Work conducted at Universidade da Região de Joinville, Joinville (SC), Brazil.

Abstract:

Background:

Objectives:

Methods:

Results:

Study limitations:

Conclusions:

Differences in the diagnosis of primary cutaneous melanoma in the public and private healthcare systems in Joinville, Santa Catarina State, Brazil^* * Work conducted at Universidade da Região de Joinville, Joinville (SC), Brazil.