Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia; School of Public Health, Queensland University of Technology, Brisbane, Australia.
Int J Cancer. 2012 Jan 1;130(1):170-8. doi: 10.1002/ijc.25996. Epub 2011 Apr 20.
This study investigated time trends and latitude differentials in the thickness distributions of invasive melanomas diagnosed in Australia between 1990 and 2006 using data from population-based cancer registries. Trends in incidence rates were calculated by sex, age group, thickness, year at diagnosis and latitude. For thin (<1.00 mm) melanomas the increase was very pronounced during the early 1990s (1990-1996, annual percentage change and 95% confidence interval: males +5.6(+3.5,+7.7); females +4.1(+1.7,+6.5), but then incidence rates became stable among both males (+0.6(-0.1,+1.4)) and females (-0.0(-0.9,+0.9)) of all ages between 1996 and 2006. In contrast, incidence of thick (>4.00 mm) melanomas continued to increase over the entire period (males +2.6(+1.9,+3.4); females +1.6(+0.6,+2.6)). Recent reductions in the incidence of thin melanomas were observed among young (<50 years) males and females, contrasted by an increase in thin melanomas among older people, and increases in thick melanomas among most age groups for males and elderly (75+) females. A strong latitude gradient in incidence rates was observed, with rates being highest in northern, more tropical areas and lowest in the most southern regions. However, the magnitude of the increase in thick melanomas was most pronounced in southern parts of Australia. The observed trends in thin melanomas can most likely be attributed to the impact of early detection and skin awareness campaigns. However, these efforts have not impacted on the continued increase in the incidence of thick melanomas, although some increase may be due to earlier detection of metastasising melanomas. This highlights the need for continued vigilance in early detection processes.
本研究利用基于人群的癌症登记数据，调查了 1990 年至 2006 年期间澳大利亚浸润性黑色素瘤厚度分布的时间趋势和纬度差异。按性别、年龄组、厚度、诊断年份和纬度计算发病率趋势。对于薄（<1.00mm）黑色素瘤，其在 20 世纪 90 年代早期的增长非常明显（1990-1996 年，年变化百分比和 95%置信区间：男性+5.6(+3.5,+7.7)；女性+4.1(+1.7,+6.5)，但随后，1996 年至 2006 年间，所有年龄段的男性（+0.6(-0.1,+1.4)）和女性（-0.0(-0.9,+0.9)）的发病率均趋于稳定。相比之下，厚（>4.00mm）黑色素瘤的发病率在整个时期仍在持续上升（男性+2.6(+1.9,+3.4)；女性+1.6(+0.6,+2.6)）。在年轻（<50 岁）男性和女性中，观察到薄黑色素瘤的发病率最近有所下降，而在老年人中，薄黑色素瘤的发病率有所上升，大多数年龄组的男性和老年（75+）女性的厚黑色素瘤发病率有所上升。观察到发病率呈很强的纬度梯度，北部、更热带地区的发病率最高，最南部地区的发病率最低。然而，澳大利亚南部地区厚黑色素瘤的增长幅度最大。薄黑色素瘤观察到的趋势很可能归因于早期检测和皮肤意识运动的影响。然而，这些努力并没有对厚黑色素瘤发病率的持续上升产生影响，尽管一些上升可能是由于转移性黑色素瘤的早期检测。这凸显了在早期检测过程中保持警惕的必要性。
