Department of Radiation Biology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
J Eur Acad Dermatol Venereol. 2011 Dec;25(12):1444-9. doi: 10.1111/j.1468-3083.2011.04023.x. Epub 2011 Mar 9.
Melanoma incidence is increasing in many parts of the world. The main environmental risk factor is exposure to solar radiation. However, melanomas may arise also on non-sun-exposed areas (uveal and mucosal melanomas) and little is known about a possible relationship between sun exposure and melanoma on such locations.
We have compared the time and latitude trends of melanoma incidence in the anorectal region and perianal skin (non-sun-exposed sites) with those of cutaneous malignant melanoma (CMM) (sun-exposed skin) to gain more information about the relationship between sun exposure and melanoma on such sites.
We analysed epidemiological data from the Cancer Registry of Norway for melanomas of the anorectal mucosa, perianal skin and overall CMM for the time period 1966-2007.
We found that melanoma incidence on these shielded sites tends to decrease or remain constant over a period during which the CMM rates increase. This is true both in the North and in the South regions of Norway. Comparison of latitudinal trends of the incidence rates of CMM and melanoma on these shielded sites shows that there is no latitude gradient for melanoma of the anorectal mucosa and perianal skin, whereas there is a strong one for CMM.
The time and latitudinal trends are likely to support the assumption that melanomas on these shielded sites are not generated by ultraviolet radiation. Possible causes and significances of these trends are discussed.
在世界许多地区,黑色素瘤的发病率正在上升。主要的环境风险因素是暴露在太阳辐射下。然而,黑色素瘤也可能出现在非暴露于阳光的区域(葡萄膜和粘膜黑色素瘤),对于这些部位的阳光暴露与黑色素瘤之间可能存在的关系知之甚少。
我们比较了肛门直肠区域和肛周皮肤(非暴露于阳光的部位)黑色素瘤的时间和纬度趋势与皮肤恶性黑色素瘤(CMM)(暴露于阳光的皮肤)的时间和纬度趋势,以获得更多关于这些部位的阳光暴露与黑色素瘤之间关系的信息。
我们分析了 1966 年至 2007 年期间挪威癌症登记处的肛门直肠粘膜、肛周皮肤和全身 CMM 的黑色素瘤的流行病学数据。
我们发现,在 CMM 发病率上升的一段时间内,这些遮蔽部位的黑色素瘤发病率呈下降或保持不变的趋势。在挪威的北部和南部地区都是如此。比较 CMM 和这些遮蔽部位黑色素瘤发病率的纬度趋势表明,肛门直肠粘膜和肛周皮肤的黑色素瘤没有纬度梯度,而 CMM 则存在很强的纬度梯度。
时间和纬度趋势可能支持这样一种假设,即这些遮蔽部位的黑色素瘤不是由紫外线辐射引起的。这些趋势的可能原因和意义进行了讨论。