Lakhani Naheed A, Saraiya Mona, Thompson Trevor D, King Sallyann Coleman, Guy Gery P
Emory University School of Medicine, USA.
Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, USA.
Prev Med. 2014 Apr;61:75-80. doi: 10.1016/j.ypmed.2014.01.003. Epub 2014 Jan 10.
Melanoma incidence and mortality are increasing among United States adults. At present, routine skin cancer screening via total body skin examinations (TBSEs) by a physician is not recommended by the United States Preventive Services Task Force (USPSTF); while organizations such as the American Cancer Society recommend screening. Currently, there are limited data on the prevalence, correlates, and trends of TBSE among United States adults.
We analyzed data by race/ethnicity, age, and skin cancer risk level, among other characteristics from three different National Health Interview Survey (NHIS) cancer control supplements conducted every five years since 2000 in random United States households. High-risk status and middle-risk status were defined based on the USPSTF criteria (age, race, sunburn, and family history).
Prevalence of having at least one TBSE increased from 14.5 in 2000 to 16.5 in 2005 to 19.8 in 2010 (P<0.0001). In 2010, screening rates were higher among the elderly, the fair-skinned, those reporting sunburn(s), and individuals with a family history of skin cancer. Approximately 104.7million (51.1%) U.S. adults are at high-risk for developing melanoma, of which 24.0% had at least one TBSE.
TBSE rates have been increasing since 2000 both overall and among higher-risk groups. Data on screening trends could help tailor future prevention strategies.
美国成年人中黑色素瘤的发病率和死亡率正在上升。目前，美国预防服务工作组（USPSTF）不建议通过医生进行全身皮肤检查（TBSE）来进行常规皮肤癌筛查；而美国癌症协会等组织则建议进行筛查。目前，关于美国成年人中TBSE的患病率、相关因素和趋势的数据有限。
我们根据种族/族裔、年龄和皮肤癌风险水平等特征，分析了自2000年以来每五年在美国随机抽取的家庭中进行的三项不同的国家健康访谈调查（NHIS）癌症控制补充调查的数据。高风险状态和中等风险状态是根据USPSTF标准（年龄、种族、晒伤和家族史）定义的。
至少进行过一次TBSE的患病率从2000年的14.5%上升到2005年的16.5%，再到2010年的19.8%（P<0.0001）。2010年，老年人、皮肤白皙者、报告有晒伤的人以及有皮肤癌家族史的人的筛查率较高。大约1.047亿（51.1%）美国成年人有患黑色素瘤的高风险，其中24.0%至少进行过一次TBSE。
自2000年以来，TBSE的比率总体上以及在高风险群体中一直在上升。筛查趋势的数据有助于制定未来的预防策略。
