Stang Andreas, Ziegler Sebastian, Büchner Ute, Ziegler Barbara, Jöckel Karl-Heinz, Ziegler Volker
Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Halle, Germany.
Int J Dermatol. 2007 Jun;46(6):564-70. doi: 10.1111/j.1365-4632.2006.03056.x.
Dermatologists have repeatedly criticized that the public health importance of nonmelanoma skin cancers is not appropriately reflected by the patient-based cancer incidence rates of population-based cancer registries. The aims of this study were to estimate the patient incidence rates of squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and skin melanoma, and to study the effect of multiple primary skin tumors on the incidence rates.
We used a network of physicians covering a population of about 75,000 individuals to register all newly diagnosed invasive skin cancers (996 diagnoses in 796 patients), including BCC, SCC, and skin melanoma, from July 1998 to June 2003. We calculated age-standardized (world standard population) incidence rates (cases per 100,000 person-years) for the first diagnoses (called "patient incidence") and for any diagnoses of BCC, SCC, and skin melanoma (called "case incidence").
The patient incidence rates of BCC were 63.6 in men and 54.0 in women, and the case incidence rates of BCC were 82.7 and 71.1, respectively. The patient incidence rates of SCC were 17.4 in men and 9.7 in women, and the case incidence rates were 20.4 and 10.2, respectively. The patient and case incidence rates of skin melanoma were about the same at 13.6 in men and 18.5 in women. Twenty-five per cent of the BCC patients and 14% of the SCC patients suffered from more than one BCC and SCC, respectively, during the 5-year period.
Patient incidence rates of BCC and SCC substantially underestimate the burden of nonmelanoma skin cancer in the population.
皮肤科医生多次批评，基于人群的癌症登记处基于患者的癌症发病率未能恰当地反映非黑色素瘤皮肤癌对公众健康的重要性。本研究的目的是估计鳞状细胞癌（SCC）、基底细胞癌（BCC）和皮肤黑色素瘤的患者发病率，并研究多发性原发性皮肤肿瘤对发病率的影响。
我们利用一个覆盖约75000人的医生网络，登记了1998年7月至2003年6月期间所有新诊断的浸润性皮肤癌（796例患者中的996例诊断），包括BCC、SCC和皮肤黑色素瘤。我们计算了首次诊断（称为“患者发病率”）以及BCC、SCC和皮肤黑色素瘤任何诊断（称为“病例发病率”）的年龄标准化（世界标准人口）发病率（每10万人年的病例数）。
BCC的患者发病率男性为63.6，女性为54.0，病例发病率分别为82.7和71.1。SCC的患者发病率男性为17.4，女性为9.7，病例发病率分别为20.4和10.2。皮肤黑色素瘤的患者发病率和病例发病率大致相同，男性为13.6，女性为18.5。在5年期间，分别有25%的BCC患者和14%的SCC患者患有不止一处BCC和SCC。
BCC和SCC的患者发病率大大低估了人群中非黑色素瘤皮肤癌的负担。
