Moan J, Dahlback A
Institute for Cancer Research, Montebello, Oslo, Norway.
Br J Cancer. 1992 Jun;65(6):916-21. doi: 10.1038/bjc.1992.192.
During the period 1957-1984 the annual age-adjusted incidence rate of cutaneous malignant melanoma (CMM) increased by 350% for men and 440% for women in Norway. The annual exposure to carcinogenic sunlight in Norway, calculated by use of measured ozone levels, showed no increasing trend during the same period. Thus, ozone depletion is not a cause of the increasing trend of the incidence rates of skin cancers. The incidence rates of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) increase with decreasing latitude in Norway. The same is true for CMM in Norway, Sweden, and Finland. Our data were used to estimate the implications of a future ozone depletion for the incidence rates of skin cancer: a 10% ozone depletion was found to give rise to a 16-18% increase in the incidence rate of SCC (men and women), a 19% increase in the incidence rate of CMM for men and a 32% increase in the incidence rate of CMM for women. The difference between the numbers for men and women is almost significant and may be related to a different intermittent exposure pattern to sunlight of the two sexes. The increasing trend in the incidence rates of CMM is strongest for the trunk and lower extremities of women, followed by that for the trunk of men. The increasing incidence rates of skin cancers as well as the changing pattern of incidence on different parts of the body is most likely due to changing habits of sun exposure. Comparisons of relative densities of CMM, SCC, LMM and SCC falling per unit area of skin at different parts of the body indicate that sun exposure is the main cause of these cancer forms although other unknown factors may play significant roles as well. For the population as a whole sun exposure during vacations to sunny countries has so far been of minor importance in skin cancer induction.
1957年至1984年期间,挪威男性皮肤恶性黑色素瘤(CMM)的年龄调整发病率每年增长350%,女性增长440%。利用实测臭氧水平计算得出,挪威同期致癌性阳光的年暴露量并无上升趋势。因此,臭氧消耗并非皮肤癌发病率上升趋势的成因。在挪威,基底细胞癌(BCC)和鳞状细胞癌(SCC)的发病率随纬度降低而升高。挪威、瑞典和芬兰的CMM情况也是如此。我们的数据被用于估计未来臭氧消耗对皮肤癌发病率的影响:发现臭氧消耗10%会使SCC(男性和女性)发病率上升16 - 18%,男性CMM发病率上升19%,女性CMM发病率上升32%。男性和女性的数据差异几乎具有显著性,可能与两性不同的间歇性阳光暴露模式有关。女性躯干和下肢CMM发病率的上升趋势最为明显,其次是男性躯干。皮肤癌发病率的上升趋势以及身体不同部位发病率变化模式很可能归因于阳光暴露习惯的改变。对身体不同部位每单位皮肤面积上CMM、SCC、肢端雀斑样痣黑色素瘤(LMM)和SCC相对密度的比较表明,阳光暴露是这些癌症类型的主要成因,尽管其他未知因素可能也起到重要作用。就总体人群而言,到阳光充足国家度假期间的阳光暴露目前在引发皮肤癌方面作用较小。