Toender Anita, Kjær Susanne K, Jensen Allan
aVirus, Lifestyle and Genes, Danish Cancer Society Research Center bGynecological Clinic, Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.
Melanoma Res. 2014 Oct;24(5):488-95. doi: 10.1097/CMR.0000000000000092.
The incidence of malignant melanoma has increased markedly among white populations in the recent decades. This may suggest that the incidence of melanoma in situ (MIS), the precursor of malignant melanoma, has also increased; however, few studies have assessed the incidence of MIS drawing on large population-based data sets. The present study aimed to assess MIS incidence trends in Denmark from 1997 to 2011. Data on MIS overall and on the histological subtypes superficial spreading MIS (SSM) and lentigo maligna (LM) were obtained from the Danish Nationwide Registry of Pathology. We calculated overall and age-specific incidence rates for both sexes, age-adjusted according to the world standard population. The average annual percentage change (AAPC) and 95% confidence intervals were calculated using log-linear Poisson models. Among both sexes, a high continued increase in MIS incidence rates overall and in that of the histological subtypes SSM and LM were observed during the period from 1997 to 2011. During this period, the age-adjusted MIS incidence rate increased from 2.6 to 8.1 cases among women and from 1.4 to 5.6 cases among men per 100 000 person-years. For both sexes, the highest AAPC in MIS incidence was observed during the most recent 5-year calendar period. A markedly higher AAPC was observed for SSM than for LM during the most recent 5-year calendar period for both sexes. The marked increase in incidence of MIS during the last 5 years of the period may indicate a growing awareness of skin cancer among the general Danish population and more frequent excision of suspicious skin lesions.
近几十年来,白人人群中恶性黑色素瘤的发病率显著上升。这可能表明原位黑色素瘤(MIS)(恶性黑色素瘤的前驱病变)的发病率也有所增加;然而,很少有研究利用基于大规模人群的数据集评估MIS的发病率。本研究旨在评估1997年至2011年丹麦MIS的发病率趋势。MIS总体以及组织学亚型浅表扩散性MIS(SSM)和恶性雀斑样痣(LM)的数据来自丹麦全国病理登记处。我们计算了男女的总体发病率和年龄特异性发病率,并根据世界标准人群进行年龄调整。使用对数线性泊松模型计算平均年度百分比变化(AAPC)和95%置信区间。在1997年至2011年期间,观察到男女的MIS总体发病率以及组织学亚型SSM和LM的发病率持续大幅上升。在此期间,年龄调整后的MIS发病率在女性中从每10万人年2.6例增加到8.1例,在男性中从1.4例增加到5.6例。对于男女而言,MIS发病率的最高AAPC出现在最近的5年日历期。在最近的5年日历期内,男女的SSM的AAPC均明显高于LM。该时期最后5年MIS发病率的显著上升可能表明丹麦普通人群对皮肤癌的认识不断提高,以及对可疑皮肤病变的切除更加频繁。