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诊断季节对恶性黑色素瘤的生存没有影响。

Season of diagnosis has no effect on survival from malignant melanoma.

作者信息

Jayasekara Harindra, Karahalios Emily, Thursfield Vicky, Giles Graham G, English Dallas R

机构信息

Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population Health, The University of Melbourne, Carlton, Victoria, Australia.

出版信息

Int J Cancer. 2009 Jul 15;125(2):488-90. doi: 10.1002/ijc.24368.

Abstract

Diagnosis in summer had been shown to be associated with better survival from some cancers, but such studies on malignant melanoma where sun exposure is a risk factor for disease are rare. We evaluated seasonality in melanoma diagnosis and its effect on survival in Victoria, Australia using 26,060 cases reported to the population-based Victorian Cancer Registry during 1986-2004. To estimate the amplitude of the seasonal variation, we calculated the ratio of the number of melanoma cases diagnosed in summer to that in winter. Linear regression was undertaken to assess the variation in thickness, the main prognostic indicator for melanoma, by season of diagnosis adjusting for sex, anatomical site, year of diagnosis and age at diagnosis. We modeled excess mortality using Poisson regression controlling for possible confounders in order to study the effect of season of diagnosis on survival. An overall 46% summer diagnostic excess was evident (summer-to-winter ratio 1.46; 95% CI 1.41, 1.52). Results of linear regression showed that melanoma diagnosed in winter were thicker than those diagnosed in any other season (percentage difference in thickness -2.01, -6.97 and -10.68 for spring, summer and autumn, respectively; p < 0.001). In the Poisson regression model of relative survival, cases diagnosed in spring, summer or autumn had slightly lower excess mortality than those diagnosed in winter before adjustment for other variables, but after adjustment the excess mortality ratios were close to unity. Our findings do not support the hypothesis that melanoma cases diagnosed in winter have worse prognosis than cases diagnosed in other seasons.

摘要

研究表明,某些癌症在夏季被诊断出来与更好的生存率相关,但针对恶性黑色素瘤(日晒是该疾病的一个风险因素)的此类研究却很少见。我们利用1986年至2004年期间向基于人群的维多利亚癌症登记处报告的26060例病例,评估了澳大利亚维多利亚州黑色素瘤诊断的季节性及其对生存的影响。为了估计季节性变化的幅度,我们计算了夏季诊断出的黑色素瘤病例数与冬季诊断出的病例数之比。采用线性回归分析,在调整性别、解剖部位、诊断年份和诊断时年龄的基础上,评估诊断季节对黑色素瘤主要预后指标厚度的影响。我们使用泊松回归模型对超额死亡率进行建模,控制可能的混杂因素,以研究诊断季节对生存的影响。夏季诊断的总体超额率为46%(夏季与冬季之比为1.46;95%置信区间为1.41,1.52)。线性回归结果显示,冬季诊断出的黑色素瘤比其他任何季节诊断出的都厚(春季、夏季和秋季厚度的百分比差异分别为-2.01、-6.97和-10.68;p<0.001)。在相对生存的泊松回归模型中,在调整其他变量之前,春季、夏季或秋季诊断出的病例超额死亡率略低于冬季诊断出的病例,但调整后超额死亡率接近1。我们的研究结果不支持冬季诊断出的黑色素瘤病例比其他季节诊断出的病例预后更差这一假设。

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