Clark Lily N, Shin Daniel B, Troxel Andrea B, Khan Shahbaz, Sober Arthur J, Ming Michael E
Department of Dermatology, University of Pennsylvania, Philadelphia, PA 19104, USA.
J Am Acad Dermatol. 2007 May;56(5):768-73. doi: 10.1016/j.jaad.2006.12.028. Epub 2007 Mar 6.
Anatomic distribution of melanoma, thought to be different between men and women, has not been studied in the United States since the 1970s, although lifestyle and clothing habits have changed since then.
To determine whether the anatomic distribution of melanoma varied between men and women at our institution in 2004 and in the 1970s, and to assess whether the anatomic distribution has changed over time.
We recorded the body location of initial primary cutaneous melanomas and assessed other variables of interest for 152 patients seen in our clinic in 2004 and in 397 patients seen between 1972 and 1977. Logistic regression was used for analysis.
For the 2004 patients, males had an increased relative risk compared to females of developing a melanoma on their head and neck (relative risk ratio [RRR] = 3.33; P = .01). For the 1970s patients, this difference was not found, but males in the 1970s had higher odds of developing melanoma on their upper back, chest, and abdomen, while females in the 1970s had higher odds of developing melanoma on the upper extremity and lower extremity, particularly the lower legs and feet. Examining differences over time, we found that women in 2004 had a decreased relative risk of developing a melanoma on the lower extremities as opposed to the trunk as compared to the 1970s (RRR = 0.42; P < .01). We also found that women had increased odds of developing a melanoma on the chest in 2004 compared to the 1970s (OR = 2.65; P = .04), while men had increased odds of developing a melanoma on their lower legs in 2004 compared to the 1970s (OR = 3.18; P = .02).
The study was performed at a single academic center and the results may not generalize to all melanoma populations. There may be important unexamined confounders.
There were significant differences between men and women in the anatomic distribution of melanoma in 2004 patients and in 1970s patients, but the nature of those differences changed over time.
黑色素瘤的解剖分布被认为在男性和女性之间存在差异，自20世纪70年代以来美国尚未对此进行研究，尽管从那时起生活方式和着装习惯已经发生了变化。
确定2004年和20世纪70年代在我们机构中黑色素瘤的解剖分布在男性和女性之间是否存在差异，并评估解剖分布是否随时间发生了变化。
我们记录了原发性皮肤黑色素瘤的初始发病部位，并评估了2004年在我们诊所就诊的152例患者以及1972年至1977年间就诊的397例患者的其他相关变量。采用逻辑回归进行分析。
对于2004年的患者，男性在头颈部发生黑色素瘤的相对风险高于女性（相对风险比[RRR]=3.33；P=0.01）。对于20世纪70年代的患者，未发现这种差异，但20世纪70年代的男性在上背部、胸部和腹部发生黑色素瘤的几率较高，而20世纪70年代的女性在上肢和下肢，尤其是小腿和足部发生黑色素瘤的几率较高。研究不同时间的差异时，我们发现与20世纪70年代相比，2004年女性下肢发生黑色素瘤相对于躯干的相对风险降低（RRR=0.42；P<0.01）。我们还发现，与20世纪70年代相比，2004年女性胸部发生黑色素瘤的几率增加（比值比[OR]=2.65；P=0.04），而与20世纪70年代相比，2004年男性小腿发生黑色素瘤的几率增加（OR=3.18；P=0.02）。
该研究在单一学术中心进行，结果可能不适用于所有黑色素瘤人群。可能存在重要的未检测到的混杂因素。
2004年患者和20世纪70年代患者中，黑色素瘤的解剖分布在男性和女性之间存在显著差异，但这些差异的性质随时间发生了变化。
