Lipsker D, Engel F, Cribier B, Velten M, Hedelin G
Clinique Dermatologique, Faculté de Médecine, Université Louis Pasteur, 1 place de l'hôpital, F-67091 Strasbourg cedex, France.
Br J Dermatol. 2007 Aug;157(2):338-43. doi: 10.1111/j.1365-2133.2007.08029.x. Epub 2007 Jun 26.
It has been suggested that the incidence of thin melanomas but not of thick tumours is rising in fair-skinned populations, although the reason for this discrepancy is not understood.
To describe temporal trends in melanoma epidemiology in a limited part of France in order to confirm this observation and to provide an explanation.
This is a retrospective population- and academic centre-based study in which all melanomas diagnosed in the department of the Bas-Rhin, France between January 1980 and December 2004 were included.
The study included 2094 melanomas diagnosed in 2020 patients. There was a steady increase in incidence of thin (< 1 mm) melanomas, mainly located on the trunk, and to a lesser extent in the head and neck region, in both sexes, and of intermediate (1-2 mm) melanomas in men. The incidence of intermediate melanomas in women and of thick (> 2 mm) melanomas, as well as mortality related to melanoma, remained stable. There was a steady decline of mean and median Breslow thickness. The 12 months median delay to diagnosis of thick tumours was significantly shorter than the 24 months delay to diagnosis of thin tumours.
Temporal trends suggest the existence of three unrelated types of melanoma: type I, thick melanomas, with stable incidence; type II, thin melanoma with a steady and important increase in incidence, mainly located on the trunk; and type III, melanoma with a slower increase in incidence, mainly located on the head and neck region.
有研究表明，在白种人群中，薄型黑色素瘤的发病率呈上升趋势，而厚型肿瘤的发病率则未上升，尽管这种差异的原因尚不清楚。
描述法国有限地区黑色素瘤流行病学的时间趋势，以证实这一观察结果并给出解释。
这是一项基于人群和学术中心的回顾性研究，纳入了1980年1月至2004年12月期间在法国下莱茵省确诊的所有黑色素瘤病例。
该研究纳入了2020例患者诊断的2094例黑色素瘤。薄型（<1mm）黑色素瘤的发病率稳步上升，主要位于躯干，在较小程度上位于头颈部，男女皆是如此；男性中厚度为中等（1 - 2mm）的黑色素瘤发病率也有所上升。女性中厚度为中等的黑色素瘤以及厚型（>2mm）黑色素瘤的发病率，以及与黑色素瘤相关的死亡率保持稳定。Breslow厚度的均值和中位数呈稳步下降。厚型肿瘤诊断的中位延迟时间为12个月，显著短于薄型肿瘤诊断的24个月延迟时间。
时间趋势表明存在三种不相关的黑色素瘤类型：I型，厚型黑色素瘤，发病率稳定；II型，薄型黑色素瘤，发病率稳步且显著上升，主要位于躯干；III型，发病率上升较慢的黑色素瘤，主要位于头颈部。
