Marks R
University of Melbourne, Department of Medicine, St Vincent's Hospital Melbourne and Skin and Cancer Foundation of Victoria, Austrialia.
Clin Exp Dermatol. 2000 Sep;25(6):459-63. doi: 10.1046/j.1365-2230.2000.00693.x.
Melanoma incidence and morality rates are increasing in most countries throughout the world where they are being recorded. The annual incidence rates have increased in the order of 3-7% in fair-skinned populations in recent decades. The mortality rates have increased at a rate lower than for incidence. This has been attributed to educational programs designed to improve the early detection of melanoma, as the treatment of melanoma has not changed substantially in recent decades. There has been a decrease in the thickness of melanoma with an increasing proportion of thin melanomas at diagnosis. Causation of melanoma is a combination of constitutional risk factors of which skin colour is the major factor. The presence and number of common acquired and dysplastic melanocytic naevi is also a major constitutional risk factor in fair-skinned people. The only environmental risk factor that has been shown consistently is exposure to sunlight, particularly large doses of sunlight sufficient to cause sunburn in childhood that will be remembered many years later. However, recreational activity leading to sunburn in adulthood is also associated with risk. To date, no other environmental factors have been shown epidemiologically to be clearly associated with risk of melanoma. Recent epidemiological data from some studies suggesting that there is an increased risk of melanoma in sunscreen users requires further explanation.
在世界上多数有记录的国家，黑色素瘤的发病率和死亡率都在上升。近几十年来，白种人群的年发病率以3%至7%的幅度增长。死亡率的增长速度低于发病率。这归因于旨在提高黑色素瘤早期检测率的教育项目，因为近几十年来黑色素瘤的治疗方法并无实质性改变。黑色素瘤的厚度有所降低，诊断时薄型黑色素瘤的比例在增加。黑色素瘤的病因是多种体质危险因素共同作用，其中肤色是主要因素。普通获得性和发育异常性黑素细胞痣的存在及数量也是白种人主要的体质危险因素。唯一一直被证实的环境危险因素是暴露于阳光，尤其是童年时期足以导致晒伤的大剂量阳光照射，多年后仍会被记住。然而，成年后导致晒伤的娱乐活动也与风险相关。迄今为止，从流行病学角度来看，尚未发现其他环境因素与黑色素瘤风险有明确关联。近期一些研究的流行病学数据表明防晒霜使用者患黑色素瘤的风险增加，这需要进一步解释。
