Sneyd Mary, Cox Brian
Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin.
N Z Med J. 2006 Sep 22;119(1242):U2169.
This study estimated the impact of prevention, screening, early diagnosis, and treatment on the burden of melanoma in New Zealand.
Cancer control plans and management guidelines were reviewed to identify activities that could reduce the burden of melanoma in New Zealand and an estimation was made of their effects on incidence and mortality. The base year for estimating changes in incidence and mortality was the published melanoma data for 2002.
The registration of melanoma increased from 1037 new registrations in 1993 to 1487 in 1994 and peaked at 1759 in 1995. In 2002 a further increase occurred, to 1842 new registrations and 235 deaths from melanoma. It is likely that 328 of the 1842 new cases of melanoma in 2002 were directly attributable to severe sunburn. A reduction of 10% in the number of people getting severely sunburnt could prevent 28 melanoma cases per year. If 2% of melanoma deaths occur in high-risk individuals, approximately 4 deaths per year could be prevented by surveillance of high-risk groups. Thin melanoma has a very good prognosis: a 10% shift in the depth distribution into the thinnest depth category would result in about 29 deaths from melanoma prevented each year.
The best avenues for reducing the burden of melanoma in New Zealand are prevention of excessive sun exposure and early diagnosis. Reducing severe sunburn and diagnosing a greater proportion of melanomas when they are thin would have the greatest impact on the incidence of and mortality from melanoma.
本研究评估了预防、筛查、早期诊断及治疗对新西兰黑色素瘤负担的影响。
对癌症控制计划和管理指南进行审查，以确定可减轻新西兰黑色素瘤负担的活动，并估计其对发病率和死亡率的影响。估计发病率和死亡率变化的基准年为2002年公布的黑色素瘤数据。
黑色素瘤的登记病例数从1993年的1037例新登记病例增加到1994年的1487例，并于1995年达到峰值1759例。2002年进一步增加，新登记病例达1842例，黑色素瘤死亡235例。2002年1842例黑色素瘤新病例中，可能有328例直接归因于严重晒伤。严重晒伤人数减少10%，每年可预防28例黑色素瘤病例。如果2%的黑色素瘤死亡发生在高危个体中，通过对高危人群的监测，每年大约可预防4例死亡。薄型黑色素瘤预后非常好：深度分布向最薄深度类别偏移10%，每年可预防约29例黑色素瘤死亡。
减轻新西兰黑色素瘤负担的最佳途径是预防过度日晒和早期诊断。减少严重晒伤以及在黑色素瘤处于薄型时诊断出更大比例的病例，将对黑色素瘤的发病率和死亡率产生最大影响。
