Osterlind A
Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
Acta Oncol. 1992;31(8):903-8. doi: 10.3109/02841869209089727.
Mortality and incidence of malignant melanoma of the skin is increasing at a rate of between 3 and 7% per year in many European countries. All over Europe melanoma is the cancer showing the most rapid increase in incidence. Within Europe the variation in incidence and mortality rates is close to a factor of ten with the disease being more common in northern than in southern Europe. Higher rates are consistently reported on intermittently exposed body sites. Skin melanoma differ from non-melanoma skin cancer with regard to sex-, age-, and anatomic distribution. There is mounting evidence from analytical studies that the increase in melanoma incidence is a result of intermittent recreational sun exposure. Severe sunburns, in particular, is a strong risk factor, being especially harmful in childhood. Outdoor work with chronic sun exposure is not associated with increased melanoma risk and it may even be protective. The total number of pigmented naevi is an important risk factor in several studies. Freckling, fair complexion, and skin which burns rather than tans at sun exposure, are other well-established risk factors. Today no non-solar environmental risk factors have been identified. Information campaigns based on our knowledge of risk factors, warning against excessive sun exposure should significantly reduce the incidence in the future. Population-based education of risk groups may lead to earlier diagnosis and thereby reduced mortality.
在许多欧洲国家，皮肤恶性黑色素瘤的死亡率和发病率正以每年3%至7%的速度上升。在整个欧洲，黑色素瘤是发病率增长最快的癌症。在欧洲内部，发病率和死亡率的差异接近10倍，该病在北欧比南欧更为常见。间歇性暴露的身体部位的发病率一直较高。皮肤黑色素瘤在性别、年龄和解剖分布方面与非黑色素瘤皮肤癌不同。分析研究中有越来越多的证据表明，黑色素瘤发病率的增加是间歇性休闲日光暴露的结果。特别是严重晒伤是一个很强的风险因素，在儿童时期尤其有害。长期暴露在阳光下的户外工作与黑色素瘤风险增加无关，甚至可能具有保护作用。在几项研究中，色素痣的总数是一个重要的风险因素。雀斑、白皙肤色以及暴露在阳光下会晒伤而非晒黑的皮肤，是其他已确定的风险因素。目前尚未发现非阳光环境风险因素。基于我们对风险因素的了解开展宣传活动，警告人们避免过度日晒，有望在未来显著降低发病率。对高危人群进行基于人群的教育可能会导致早期诊断，从而降低死亡率。
