Stefansson H, Tryggvadottir L, Olafsdottir E J, Mooney E, Olafsson J H, Sigurgeirsson B, Jonasson J G
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Department of Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.
J Eur Acad Dermatol Venereol. 2015 Feb;29(2):346-352. doi: 10.1111/jdv.12552. Epub 2014 Jun 9.
The incidence of cutaneous melanoma increased dramatically in Iceland during the last two decades of the 20th century.
The aim of this study was to investigate the trend in Breslow's tumour thickness during the years 1980-2009.
The population-based Icelandic Cancer Registry provided information on all cutaneous melanomas diagnosed in the country during the study period, a total of 854 cases. Incidence rates were stratified according to gender, age at diagnosis, year of diagnosis and Breslow's tumour thickness.
When stratified by gender and age, the incidence of thin (≤1.0 mm) melanomas increased dramatically in all subgroups. The increase in thin (≤1.0 mm) melanomas was more apparent in women or 2.6 per 100,000 in 1980-1989 to 13.3 in 2000-2009 and especially in young (<50 years) women or from 1.6 to 12.2 per 100,000 during the same period compared to an increase from 0.2 to 3.4 per 100,000 for young (<50 years) men (P < 0.05). In intermediate thickness (1.01-4.0 mm) tumours, the incidence increased only in men over the age of 50 from 2.1 in 1980-1989 to 11.3 per 100,000 in 2000-2009 (P < 0.05). The incidence of thick melanomas (>4 mm) did not increase. The median Breslow's thickness declined from 2.15 mm in 1980-1989 to 0.9 mm in 2000-2009 in males and from 1.0 to 0.6 mm in females for the same period (P < 0.001).
The rise in melanoma incidence in individuals under 50 years and in women over 50 years was confined to thin tumours. However, among older males there was also an increased incidence of tumours of an intermediate thickness. This could indicate that future melanoma educational campaigns in Iceland should be directed at older individuals, and that older men may need special attention regarding suspicious nevi.
在20世纪的最后二十年里，冰岛皮肤黑色素瘤的发病率急剧上升。
本研究旨在调查1980年至2009年间布雷斯洛肿瘤厚度的变化趋势。
基于人群的冰岛癌症登记处提供了研究期间该国诊断出的所有皮肤黑色素瘤的信息，共计854例。发病率按性别、诊断时年龄、诊断年份和布雷斯洛肿瘤厚度进行分层。
按性别和年龄分层时，所有亚组中薄型（≤1.0 mm）黑色素瘤的发病率均急剧上升。薄型（≤1.0 mm）黑色素瘤的增加在女性中更为明显，从1980 - 1989年的每10万人2.6例增至2000 - 2009年的13.3例，尤其是年轻（<50岁）女性，同期从每10万人1.6例增至12.2例，而年轻（<50岁）男性则从每10万人0.2例增至3.4例（P < 0.05）。在中等厚度（1.01 - 4.0 mm）的肿瘤中，仅50岁以上男性的发病率有所增加，从1980 - 1989年的每10万人2.1例增至2000 - 2009年的11.3例（P < 0.05）。厚黑色素瘤（>4 mm）的发病率没有增加。同期男性的布雷斯洛厚度中位数从1980 - 1989年的2.15 mm降至2000 - 2009年的0.9 mm，女性从1.0 mm降至0.6 mm（P < 0.001）。
50岁以下个体和50岁以上女性黑色素瘤发病率的上升仅限于薄型肿瘤。然而，在老年男性中，中等厚度肿瘤的发病率也有所增加。这可能表明，冰岛未来的黑色素瘤教育活动应针对老年人，并且老年男性在可疑痣方面可能需要特别关注。
