Crutcher W A, Cohen P J
Children's Hospital of San Franscisco, California.
Am Fam Physician. 1990 Aug;42(2):372-85.
The incidence of melanoma has been steadily increasing, with a trend for this tumor to develop at younger ages. The only satisfactory treatment for melanoma is early intervention; therefore, routine screening for melanoma and dysplastic nevi during the general physical examination is important. The prevalence of dysplastic nevi is estimated to be 2 to 5 percent. Patients with dysplastic nevi appear to have at least a 6 percent lifetime risk of melanoma. In the most severely affected patients (those with a family history of dysplastic nevi and more than one melanoma), the lifetime risk may exceed 50 percent. Patients with dysplastic nevi merit periodic follow-up. Since these nevi tend to be familial, close relatives of affected patients may also benefit from a screening examination. Individuals at increased risk for melanoma may display one or more of the following risk factors: dysplastic nevi, freckling, tendency to sunburn and numerous common nevi. Such individuals may benefit most from education in sunburn avoidance, sunscreen use and self-examination for changing nevi. A better informed public and heightened physician awareness are the most effective means of reducing mortality from this virulent malignancy.
黑色素瘤的发病率一直在稳步上升，且有在更年轻年龄段发病的趋势。黑色素瘤唯一令人满意的治疗方法是早期干预；因此，在常规体检期间对黑色素瘤和发育异常痣进行筛查很重要。发育异常痣的患病率估计为2%至5%。患有发育异常痣的患者一生中患黑色素瘤的风险至少为6%。在受影响最严重的患者（有发育异常痣家族史且患有一种以上黑色素瘤的患者）中，终生风险可能超过50%。患有发育异常痣的患者值得定期随访。由于这些痣往往具有家族性，受影响患者的近亲也可能从筛查检查中受益。黑色素瘤风险增加的个体可能表现出以下一种或多种风险因素：发育异常痣、雀斑、容易晒伤和有大量普通痣。这类个体可能从避免晒伤、使用防晒霜和自我检查痣的变化等教育中获益最大。公众了解更多信息以及医生提高认识是降低这种恶性肿瘤死亡率的最有效手段。
