Iannacone Michelle R, Youlden Danny R, Baade Peter D, Aitken Joanne F, Green Adèle C
Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Int J Cancer. 2015 Feb 1;136(3):603-9. doi: 10.1002/ijc.28956. Epub 2014 May 17.
Cutaneous melanoma is a relatively common cancer in adolescents and young adults in Australia, but detailed information about occurrence patterns and prognosis is limited. We evaluated incidence trends from 1982 to 2010 and recent survival rates in those aged 15-24 years in the state of Queensland. In situ and invasive melanoma cases were identified from the Queensland Cancer Registry. Incidence rates were age-standardised to the 2000 World population and trends calculated using joinpoint regression. Five-year relative survival was estimated by the period method and Poisson models were used to produce adjusted mortality hazard ratios. Average annual incidence rates for the 5-year period 2006-2010 were 6.3 per 100,000 [95% confidence interval (CI) 5.4, 7.2] for in situ and 10.1 per 100,000 (95% CI 9.0, 11.3) for invasive melanoma. Since the mid-1990s, incidence rates for in situ melanomas have been stabilizing while invasive melanoma has decreased in both sexes, mainly owing to declining rates of thin tumours (≤1 mm) (-5.4% per year, 95% CI -8.3%, -2.4%). Incidence rates of melanomas >1 mm in thickness have remained relatively unchanged since 1991 however. In the period 2006-2010, relative 5-year survival of 15-24 year olds with invasive melanoma was 95.7% (95% CI 92.9%, 97.5%). The subgroup with tumours >1 mm was nearly six times more likely to die within 5 years than those with thin tumours (adjusted hazard ratio = 5.53, 95% CI 1.72, 17.80). Incidence of thin melanoma in young people in Queensland is declining, suggesting benefits of primary prevention efforts are being realised.
皮肤黑色素瘤在澳大利亚青少年和青年中是一种相对常见的癌症，但关于其发病模式和预后的详细信息有限。我们评估了1982年至2010年昆士兰州15至24岁人群的发病率趋势和近期生存率。原位和侵袭性黑色素瘤病例从昆士兰癌症登记处识别。发病率按2000年世界人口进行年龄标准化，并使用连接点回归计算趋势。通过时期法估计5年相对生存率，并使用泊松模型产生调整后的死亡风险比。2006 - 2010年这5年期间原位黑色素瘤的年均发病率为每10万人6.3例[95%置信区间(CI) 5.4, 7.2]，侵袭性黑色素瘤为每10万人10.1例(95% CI 9.0, 11.3)。自20世纪90年代中期以来，原位黑色素瘤的发病率一直稳定，而侵袭性黑色素瘤在两性中均有所下降，主要是由于薄肿瘤(≤1毫米)发病率下降(-每年5.4%，95% CI - 8.3%，- 2.4%)。然而，自1991年以来，厚度>1毫米的黑色素瘤发病率相对保持不变。在2006 - 2010年期间，15 - 24岁侵袭性黑色素瘤患者的5年相对生存率为95.7%(95% CI 92.9%，97.5%)。肿瘤>1毫米的亚组在5年内死亡的可能性几乎是薄肿瘤亚组的6倍(调整后的风险比= 5.53，95% CI 1.72，17.80)。昆士兰州年轻人中薄黑色素瘤的发病率正在下降，表明一级预防措施的益处正在显现。
