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近期皮肤自我检查和就诊与黑色素瘤风险和肿瘤深度的关系。

Recent skin self-examination and doctor visits in relation to melanoma risk and tumour depth.

机构信息

Department of Community and Family Medicine, Dartmouth Medical School, Norris Cotton Cancer Center, Lebanon, NH 03756, USA.

出版信息

Br J Dermatol. 2013 Mar;168(3):571-6. doi: 10.1111/bjd.12003. Epub 2012 Oct 5.

Abstract

BACKGROUND

Little is known about the potential benefit of skin self-examination for melanoma prevention and early detection.

OBJECTIVES

To determine whether skin self-examination is associated with reduced melanoma risk, self-detection of tumours, and reduced risk of deeper melanomas.

METHODS

We used data from a population-based case-control study (423 cases, 678 controls) to assess recent skin self-examination in relation to self-detection, melanoma risk and tumour depth ( ≤1 mm; > 1 mm). Logistic regression was used to estimate odds ratios (ORs) and confidence intervals (CIs) for associations of interest.

RESULTS

Skin self-examination conducted 1-11 times during a recent year was associated with a possible decrease in melanoma risk (OR 0·74; 95% CI 0·54-1·02). Melanoma risk was decreased for those who conducted skin self-examination and saw a doctor (OR 0·52; 95% CI 0·30-0·90). Among cases, those who examined their skin were twice as likely to self-detect the melanoma (OR 2·23; 95% CI 1·47-3·38), but self-detection was not associated with shallower tumours. Tumour depth was reduced for those who conducted skin self-examination 1-11 times during a recent year (OR 0·39; 95% CI 0·18-0·81), but was not influenced by seeing a doctor, or by conducting skin self-examination and seeing a doctor.

CONCLUSIONS

Risk of a deeper tumour and possibly risk of melanoma were reduced by skin self-examination 1-11 times annually. Melanoma risk was markedly reduced by skin self-examination coupled with a doctor visit. We cannot, however, exclude the possibility that our findings reflect bias or confounding. Additional studies are needed to elucidate the potential benefits of skin self-examination for melanoma prevention and early detection.

摘要

背景

对于皮肤自我检查在预防和早期发现黑色素瘤方面的潜在益处,人们知之甚少。

目的

确定皮肤自我检查是否与降低黑色素瘤风险、自我发现肿瘤以及降低深层黑色素瘤风险相关。

方法

我们使用了一项基于人群的病例对照研究(423 例病例,678 例对照)的数据,评估了最近一年中进行皮肤自我检查与自我发现、黑色素瘤风险和肿瘤深度(≤1mm;>1mm)之间的关系。采用逻辑回归来估计感兴趣关联的比值比(OR)和置信区间(CI)。

结果

在最近一年中进行 1-11 次皮肤自我检查与黑色素瘤风险可能降低相关(OR 0.74;95%CI 0.54-1.02)。对于那些进行了皮肤自我检查并看了医生的人,黑色素瘤风险降低(OR 0.52;95%CI 0.30-0.90)。在病例中,那些检查皮肤的人自我发现黑色素瘤的可能性是其他人的两倍(OR 2.23;95%CI 1.47-3.38),但自我发现与肿瘤较浅无关。在最近一年中进行 1-11 次皮肤自我检查的患者肿瘤深度降低(OR 0.39;95%CI 0.18-0.81),但看医生或进行皮肤自我检查并看医生不会影响肿瘤深度。

结论

每年进行 1-11 次皮肤自我检查可降低深层肿瘤的风险和可能的黑色素瘤风险。皮肤自我检查加上看医生可显著降低黑色素瘤风险。然而,我们不能排除我们的发现反映了偏差或混杂的可能性。需要进一步的研究来阐明皮肤自我检查在预防和早期发现黑色素瘤方面的潜在益处。

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