Lasithiotakis Konstantinos G, Leiter Ulrike, Gorkievicz Roman, Eigentler Thomas, Breuninger Helmut, Metzler Gisela, Strobel Waltraud, Garbe Claus
Section of Dermatological Oncology, Department of Dermatology, Central Malignant Melanoma Registry of the German Dermatological Society, Eberhard-Karls University, Tuebingen, Germany.
Cancer. 2006 Sep 15;107(6):1331-9. doi: 10.1002/cncr.22126.
Cutaneous melanoma (CM) incidence and mortality have risen dramatically during the past 2 generations, particularly among Caucasian populations. Detailed, long-term trends of CM in relation to clinical and pathologic characteristics in a Central European population have not been published to date.
The current study was based on 1980 patients with invasive CM diagnosed in Southern Germany during the years from 1976 to 2003 documented by the Central Malignant Melanoma Registry. The German standard population was used to calculate age-standardized rates, and the annual percent change was estimated by using age, anatomic site, histologic type, and tumor thickness.
During the study period, the incidence of CM approximately was tripled for males and females, reaching 10.3 and 13.3 per 100,000 per year, respectively (P < .001). The largest increases occurred for melanoma localized on the upper limbs (annual change, 5.9% for males and 5.0% for females; P < .001) and superficially spreading melanoma (annual change, 7.8% for males and 5.9% for females; P < .001). Thin tumors (Breslow thickness <1 mm) were presented significantly more often during the study period (annual change, 9.8% for males and 6.1% for females; P < .001), predominantly in younger patients. Thick tumors and nodular melanomas were more frequent among older patients (age >70 years), particularly among males. The age-standardized mortality decreased from 1.5 to 0.8 per 100,000 males and from 2.6 to 0.8 per 100,000 females with a significant downward trend for the female population (P < .001).
The current results indicated which diverging trends between incidence and mortality may be explained by improved public awareness regarding suspicious pigmented lesions and the earlier detection of these tumors. Continuation of the current preventive strategy and its expansion to include older age groups in the population are warranted.
在过去两代人中，皮肤黑色素瘤（CM）的发病率和死亡率急剧上升，尤其是在白种人群体中。迄今为止，尚未发表关于中欧人群中CM与临床和病理特征相关的详细长期趋势。
本研究基于1980例1976年至2003年间在德国南部被诊断为侵袭性CM的患者，这些患者由中央恶性黑色素瘤登记处记录。使用德国标准人群计算年龄标准化率，并通过年龄、解剖部位、组织学类型和肿瘤厚度估计年度百分比变化。
在研究期间，男性和女性CM的发病率大约增加了两倍，分别达到每年每10万人中10.3例和13.3例（P <.001）。上肢部位的黑色素瘤增长最为显著（男性年度变化为5.9%，女性为5.0%；P <.001）以及浅表扩散型黑色素瘤（男性年度变化为7.8%，女性为5.9%；P <.001）。在研究期间，薄肿瘤（Breslow厚度<1mm）出现的频率显著更高（男性年度变化为9.8%，女性为6.1%；P <.001），主要出现在年轻患者中。厚肿瘤和结节性黑色素瘤在老年患者（年龄>70岁）中更为常见，尤其是男性。男性年龄标准化死亡率从每10万人中1.5例降至0.8例，女性从每10万人中2.6例降至0.8例，女性人群呈显著下降趋势（P <.001）。
目前的结果表明，发病率和死亡率之间的不同趋势可能是由于公众对可疑色素沉着病变的认识提高以及这些肿瘤的早期发现。有必要继续当前的预防策略并将其扩展至包括老年人群体。
