Stritch School of Medicine, Loyola University Chicago, Maywood, IL, U.S.A.
Br J Dermatol. 2015 Apr;172(4):885-915. doi: 10.1111/bjd.13500. Epub 2015 Mar 4.
Evidence of social determinants of disease and awareness of the impact of these factors on outcomes continues to increase. Social determinants include both socioeconomic and lifestyle factors. This review examines the interface between socioeconomic status (SES) and lifestyle and their effects on melanoma incidence and mortality. Lifestyle factors including occupation, occupational exposures, body mass index, marital status, smoking, recreational sun exposure and tanning were explored as they have a known relationship with melanoma. A remarkable association of SES with melanoma incidence and prognosis has been acknowledged worldwide. Melanoma incidence is increased in populations of higher SES, especially among the highly educated, while lower SES populations present with later-stage disease at time of diagnosis and display greater mortality. The aforementioned lifestyle factors are also related to SES, and have been shown internationally to affect melanoma incidence and mortality. This comprehensive systematic review suggests that lifestyle factors including occupation, occupational exposure, obesity, recreational sun exposure and tanning may explain the relationship between SES and melanoma.
疾病的社会决定因素的证据以及这些因素对结果的影响的认识不断增加。社会决定因素包括社会经济和生活方式因素。这篇综述考察了社会经济地位（SES）与生活方式之间的相互作用及其对黑色素瘤发病率和死亡率的影响。生活方式因素，包括职业、职业暴露、体重指数、婚姻状况、吸烟、休闲日光暴露和晒黑，因为它们与黑色素瘤有已知的关系而被探讨。SES 与黑色素瘤发病率和预后的显著相关性已在全球范围内得到承认。SES 较高的人群中黑色素瘤发病率增加，尤其是受教育程度较高的人群，而 SES 较低的人群在诊断时表现出更晚期的疾病，死亡率更高。上述生活方式因素也与 SES 有关，并且国际上已经表明它们会影响黑色素瘤的发病率和死亡率。这项全面的系统综述表明，包括职业、职业暴露、肥胖、休闲日光暴露和晒黑在内的生活方式因素可能解释了 SES 与黑色素瘤之间的关系。
