Schüler G, Hardmeier T
Departement Pathologie, Universität Zürich.
Ther Umsch. 1999 Jun;56(6):292-7. doi: 10.1024/0040-5930.56.6.292.
Melanoma incidence rates in Switzerland are very high for European standards. Incidence is increasing like in other white populations; melanoma mortality has stopped its secular increase and is decreasing in people under the age of 65. The reasons for the high melanoma rates in Switzerland can only be guessed: Switzerland is a rich country (melanoma is more prevalent among the rich); the Swiss are known to spend their vacations in Southern countries, exposing themselves to the sun. The paradox of increasing incidence and decreasing mortality rates is discussed, also from the view of the histopathologist. Melanoma patients are at increased risk for subsequent skin carcinoma (basalioma/spinalioma) and vice versa. This may be explained by the common risk factor: sun exposure. The importance of primary prevention is stressed; the Swiss Cancer League is organising annual education campaigns among youngsters. Secondary prevention should focus on high risk groups: families prone to melanoma; older men.
按照欧洲标准,瑞士的黑色素瘤发病率非常高。发病率如同其他白人人群一样在上升;黑色素瘤死亡率已停止长期上升趋势,且在65岁以下人群中呈下降趋势。瑞士黑色素瘤发病率高的原因只能靠猜测:瑞士是一个富裕国家(黑色素瘤在富人中更普遍);众所周知,瑞士人在南方国家度假,使自己暴露在阳光下。本文还从组织病理学家的角度讨论了发病率上升和死亡率下降的矛盾现象。黑色素瘤患者患后续皮肤癌(基底细胞癌/棘细胞癌)的风险增加,反之亦然。这可能由共同的风险因素——阳光照射来解释。强调了一级预防的重要性;瑞士癌症联盟每年都在年轻人中组织教育活动。二级预防应关注高危人群:易患黑色素瘤的家族;老年男性。