Marrett L D, Nguyen H L, Armstrong B K
Division of Preventive Oncology, Cancer Care Ontario, Toronto, Ontario, Canada.
Int J Cancer. 2001 May 1;92(3):457-62. doi: 10.1002/ijc.1203.
The incidence of cutaneous malignant melanoma (CMM) has been rising in fair-skinned populations throughout the world for decades. The upward trend may, however, finally be slowing in some of these populations. Recent (1983-1996) CMM incidence trends for a high incidence area (New South Wales, Australia) have been examined according to gender, age group, body site and tumour thickness. Despite continuing upward trends in older age groups, particularly among men (e.g., 7.20% increase per year in men aged 75+), incidence for younger ages is stabilizing (in men) or declining (in women): average annual percentage changes of -3.03 and -0.88 were observed for women aged 15-34 and 35-54, respectively. Patterns suggest a birth-cohort effect, with those born since 1945 or 1950 having lower (females) or similar (males) rates to those born earlier. For each gender, all-ages incidence rose by a similar amount for each of the main body sites except the leg in women, where incidence fell by 0.49% per year. In men, the incidence of both thin (</=75 mm) and thick (>75 mm) melanomas increased (significantly, by 2.63% per year and non-significantly, by 0.93% per year, respectively) between 1989 and 1996. In women, incidence remained stable for both thickness subgroups. These data are consistent with a stabilization or reduction in either total sun exposure or intermittency of exposure among New South Wales cohorts born since about 1950. Because incidence rates are still much higher than they were a few decades ago, however, efforts to reduce sun exposure, particularly in children and youth, must continue.
几十年来，皮肤恶性黑色素瘤（CMM）在全球白种人群中的发病率一直在上升。然而，在其中一些人群中，这种上升趋势最终可能正在放缓。最近（1983 - 1996年），对一个高发病率地区（澳大利亚新南威尔士州）的CMM发病率趋势，按性别、年龄组、身体部位和肿瘤厚度进行了研究。尽管老年人群体的发病率持续上升，尤其是男性（例如，75岁及以上男性每年上升7.20%），但年轻人群的发病率在男性中趋于稳定，在女性中则呈下降趋势：15 - 34岁和35 - 54岁女性的年均变化率分别为 - 3.03%和 - 0.88%。发病模式显示出一种出生队列效应，即1945年或1950年以后出生的女性发病率较低，男性发病率与更早出生的人相似。对于每种性别，除女性腿部发病率每年下降0.49%外，各主要身体部位的全年龄段发病率上升幅度相似。在男性中，1989年至1996年间，薄型（≤75mm）和厚型（>75mm）黑色素瘤的发病率均有所上升（分别显著上升2.63%/年和非显著上升0.93%/年）。在女性中，两个厚度亚组的发病率均保持稳定。这些数据与自1950年左右出生的新南威尔士队列人群的总日照量稳定或减少，或日照间歇性减少相一致。然而，由于发病率仍远高于几十年前，因此减少日照暴露的努力，尤其是在儿童和青少年中，必须继续。
