Surveillance Research, American Cancer Society, Atlanta, Georgia 30303, USA.
J Am Acad Dermatol. 2011 Nov;65(5 Suppl 1):S17-25.e1-3. doi: 10.1016/j.jaad.2011.04.032.
Increasing cutaneous melanoma incidence rates in the United States have been attributed to heightened detection of thin (≤ 1-mm) lesions.
We sought to describe melanoma incidence and mortality trends in the 12 cancer registries covered by the Surveillance, Epidemiology, and End Results program and to estimate the contribution of thin lesions to melanoma mortality.
We used joinpoint analysis of Surveillance, Epidemiology, and End Results incidence and mortality data from 1992 to 2006.
During 1992 through 2006, melanoma incidence rates among non-Hispanic whites increased for all ages and tumor thicknesses. Death rates increased for older (>65 years) but not younger persons. Between 1998 to 1999 and 2004 to 2005, melanoma death rates associated with thin lesions increased and accounted for about 30% of the total melanoma deaths.
Availability of long-term incidence data for 14% of the US population was a limitation.
The continued increases in melanoma death rates for older persons and for thin lesions suggest that the increases may partly reflect increased ultraviolet radiation exposure. The substantial contribution of thin lesions to melanoma mortality underscores the importance of standard wide excision techniques and the need for molecular characterization of the lesions for aggressive forms.
美国皮肤黑色素瘤发病率的增加归因于对薄(≤1 毫米)病变的检测能力提高。
我们旨在描述美国监测、流行病学和最终结果计划涵盖的 12 个癌症登记处的黑色素瘤发病率和死亡率趋势,并估计薄病变对黑色素瘤死亡率的贡献。
我们使用监测、流行病学和最终结果发病率和死亡率数据的 Joinpoint 分析,这些数据来自 1992 年至 2006 年。
在 1992 年至 2006 年期间,所有年龄段和肿瘤厚度的非西班牙裔白人黑色素瘤发病率均有所增加。死亡率仅在年龄较大(>65 岁)的人群中增加,而在年轻人群中没有增加。在 1998 年至 1999 年和 2004 年至 2005 年之间,与薄病变相关的黑色素瘤死亡率增加,约占黑色素瘤总死亡人数的 30%。
美国 14%的人口缺乏长期发病率数据,这是一个局限性。
老年人和薄病变的黑色素瘤死亡率持续增加表明,这种增加可能部分反映了紫外线辐射暴露的增加。薄病变对黑色素瘤死亡率的大量贡献突显了标准广泛切除技术的重要性,以及对侵袭性形式的病变进行分子特征分析的必要性。