e21524 Background: Epidemiological data on melanoma from conflict-affected regions like Syria are critically scarce, hindering effective disease management and resource allocation. This study aims to address this gap by providing the first analysis of the demographic and clinical characteristics of patients diagnosed with new-onset melanoma at Syria's principal oncology referral center over four years. Methods: We conducted a retrospective, hospital-based epidemiological study at Al-Bairouni University Hospital, the national cancer center serving approximately 70% of Syria's oncology population. All patients with a new histopathological diagnosis of cutaneous melanoma between 1 January 2022 and 31 December 2025 were included. Data on demographics (age, sex, and governorate of residence), clinical characteristics (cancer stage, grade), and smoking status were extracted from medical records. Patients were grouped by diagnosis year to analyze temporal trends. The study was approved by the local institutional review board. Results: A total of 175 patients were diagnosed with Melanoma during the study period: 33 in 2022, 32 in 2023, 57 in 2024, and 53 in 2025 (Table 1). Across all years, a consistent male predominance was observed (60.1%). The average age at diagnosis was 56.1 years, 40.1% of patients were smokers, and 64.5% of all cases had advanced/metastatic disease at diagnosis. The highest patient loads originated from Damascus (16.5%) and Rural Damascus (9%), followed by central governorates such as Homs (14.7%) and Hama (16.5%). Notably, patients from more distant and underserved governorates such as Deir ez-Zor (4.1%), Aleppo (12.2%), and Al-Hasakeh (4.1%) accounted for a significant proportion of the melanoma presenting to our center. Men presented with advanced-stage melanoma significantly more often than women (75% vs. 52%, p = 0.01), which was the only significant predictor in multivariate regression analysis. Age was not associated with disease stage (p > 0.05). Conclusions: This study presents the first multi-year, nationwide dataset on melanoma in Syria, encompassing all 14 governorates. Our findings reveal a critical burden of disease, with close to half of all patients diagnosed at an advanced stage and over one-third identified as smokers. These actionable insights underscore the critical need for targeted public health strategies focused on tobacco control and enhanced early detection programs. This dataset provides a vital foundation for guiding these interventions and future research in the region. Diagnosis 2022 Cases 2023 Cases 2024 Cases 2025 Cases Total cases Average Age SexMale (%) Smokers (%) High grade Advanced/Metastatic at diagnosis melanoma 33 32 57 53 175 56.1 55.7% 40.1% 86.8% 64.5%
Al-Jojo et al. (Thu,) studied this question.