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非黑素瘤皮肤癌后绝经后女性的皮肤黑色素瘤:女性健康倡议观察性研究

Cutaneous melanoma in postmenopausal women after nonmelanoma skin carcinoma: the Women's Health Initiative Observational Study.

作者信息

Rosenberg Carol A, Khandekar Janardan, Greenland Philip, Rodabough Rebecca J, McTiernan Anne

机构信息

Department of Medicine, Evanston Northwestern Healthcare, Evanston, Illinois 60201, USA.

出版信息

Cancer. 2006 Feb 1;106(3):654-63. doi: 10.1002/cncr.21627.

Abstract

BACKGROUND

An elevated risk for cutaneous melanoma has been reported in individuals with nonmelanoma skin carcinoma (NMSC), but to the authors' knowledge, this association has not been prospectively studied in a large, multigeographic population of postmenopausal women.

METHODS

The association between NMSC and the incidence of cutaneous melanoma was assessed in the Women's Health Initiative Observational Study involving 67,030 non-Hispanic white postmenopausal women ages 50-79 years and who were free of prior other cancers at baseline. Cancer history, demographics, and previous and current risk exposures were determined by questionnaires at baseline and follow-up. Participants' reports of incident cutaneous melanoma collected annually were confirmed by physician review of medical records. Cox proportional hazards analyses were used to assess the relation of prior NMSC with incident cutaneous melanoma.

RESULTS

In age-adjusted analysis, women with a history of NMSC but no other malignancy (n = 5552) were found to be 2.41 times more likely to develop cutaneous melanoma over a mean 6.5 years compared with women who had no history of NMSC (95% confidence interval [95% CI], 1.82-3.20). In a multivariate analysis, women with a history of NMSC and no other cancer history at baseline were 1.70 times more likely to develop cutaneous melanoma compared with women without NMSC (95% CI, 1.18-2.44).

CONCLUSION

The results of the current study provide evidence and further defines the magnitude of increased risk for cutaneous melanoma in postmenopausal non-Hispanic white women with a history of NMSC.

摘要

背景

非黑色素瘤皮肤癌(NMSC)患者发生皮肤黑色素瘤的风险有所升高,但据作者所知,尚未在大型多地区绝经后女性人群中对这种关联进行前瞻性研究。

方法

在女性健康倡议观察性研究中,评估了NMSC与皮肤黑色素瘤发病率之间的关联,该研究纳入了67030名年龄在50 - 79岁之间、基线时无其他癌症病史的非西班牙裔白人绝经后女性。通过基线和随访时的问卷调查确定癌症病史、人口统计学特征以及既往和当前的风险暴露情况。每年收集的参与者新发皮肤黑色素瘤报告经医生查阅病历进行确认。采用Cox比例风险分析评估既往NMSC与新发皮肤黑色素瘤之间的关系。

结果

在年龄调整分析中,发现有NMSC病史但无其他恶性肿瘤病史的女性(n = 5552)在平均6.5年的时间里发生皮肤黑色素瘤的可能性是无NMSC病史女性的2.41倍(95%置信区间[95%CI],1.82 - 3.20)。在多变量分析中,基线时有NMSC病史且无其他癌症病史的女性发生皮肤黑色素瘤的可能性是无NMSC女性的1.70倍(95%CI,1.18 - 2.44)。

结论

本研究结果提供了证据,并进一步明确了有NMSC病史的绝经后非西班牙裔白人女性发生皮肤黑色素瘤风险增加的程度。

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