Stang Andreas, Parkin Donald Maxwell, Ferlay Jaques, Jöckel Karl-Heinz
Institute of Medical Epidemiology, Biometry and Informatics, University Clinics of Halle, Saale, Germany.
Int J Cancer. 2005 Mar 10;114(1):114-23. doi: 10.1002/ijc.20690.
The introduction of eye-preserving therapies for uveal melanoma in the 1970s complicates time trend analyses of the uveal melanoma incidence because the proportion of morphologically verified uveal melanoma has been decreasing over the decades. We carried out incidence trend analyses, based on data from internationally accredited population-based cancer registries throughout the world that take missing data on topography, morphology and basis of diagnosis of eye tumours into account. We selected incidence data of cancer registries that were included in Cancer Incidence In 5 Continents, Volumes VI-VIII covering a registration period of at least 15 years (usually 1983 to 1997) and classified each eye cancer as morphologically verified uveal melanoma, clinically diagnosed uveal melanoma, uveal melanoma identified as DCO case (Death certificate only), possibly uveal melanoma, other eye tumour or unclassifiable eye tumour and calculated age-standardized incidence rates by 3-year calendar periods using the World Standard Population as the reference. The uveal melanoma incidence decline in the United States SEER Caucasian population is due mainly to an incidence decline in the early registration period (from 1974-76 to 1986-88). The data from France and Italy suggest a recent increase in incidence. Uveal melanoma diagnosed clinically increasingly contribute to the overall uveal melanoma incidence over time. Combining all registries, the proportion of morphologically verified uveal melanoma decreased from 82% in 1983-87 to 75% in 1993-97. Uveal melanoma incidence rates remained quite stable during the period 1983-97. The interpretation of uveal melanoma incidence trends is complicated by missing data on topography within the eye, morphology and basis of diagnosis.
20世纪70年代葡萄膜黑色素瘤保眼治疗方法的引入，使葡萄膜黑色素瘤发病率的时间趋势分析变得复杂，因为数十年来，经形态学证实的葡萄膜黑色素瘤比例一直在下降。我们基于来自世界各地国际认可的基于人群的癌症登记处的数据进行发病率趋势分析，这些数据考虑了眼肿瘤的部位、形态学和诊断依据方面的缺失数据。我们选择了《五大洲癌症发病率》第六至八卷中包含的癌症登记处的发病率数据，这些数据涵盖至少15年的登记期（通常为1983年至1997年），并将每例眼癌分类为经形态学证实的葡萄膜黑色素瘤、临床诊断的葡萄膜黑色素瘤、被确定为仅死亡证明（DCO）病例的葡萄膜黑色素瘤、可能的葡萄膜黑色素瘤、其他眼肿瘤或无法分类的眼肿瘤，并以世界标准人口为参考，按3年日历期计算年龄标准化发病率。美国监测、流行病学和最终结果（SEER）白种人群中葡萄膜黑色素瘤发病率的下降主要归因于早期登记期（从1974 - 1976年至1986 - 1988年）发病率的下降。来自法国和意大利的数据表明近期发病率有所上升。随着时间的推移，临床诊断的葡萄膜黑色素瘤在总体葡萄膜黑色素瘤发病率中的占比越来越大。综合所有登记处的数据，经形态学证实的葡萄膜黑色素瘤比例从1983 - 1987年的82%降至1993 - 1997年的75%。1983 - 1997年期间，葡萄膜黑色素瘤发病率保持相当稳定。眼内部位、形态学和诊断依据方面的缺失数据使葡萄膜黑色素瘤发病率趋势的解读变得复杂。
