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非裔美国人的黑色素瘤风险认知与预防行为:少数族裔黑色素瘤悖论

Melanoma risk perception and prevention behavior among African-Americans: the minority melanoma paradox.

作者信息

Goldenberg Alina, Vujic Igor, Sanlorenzo Martina, Ortiz-Urda Susana

机构信息

Department of Internal Medicine/Dermatology, University of California, San Diego, CA, USA.

Mt Zion Cancer Research Center, University of California San Francisco, San Francisco, CA, USA ; Department of Dermatology, The Rudolfstiftung Hospital, Academic Teaching Hospital, Medical University Vienna, Vienna, Austria.

出版信息

Clin Cosmet Investig Dermatol. 2015 Aug 5;8:423-9. doi: 10.2147/CCID.S87645. eCollection 2015.

Abstract

INTRODUCTION

Melanoma is the most deadly type of skin cancer with 75% of all skin cancer deaths within the US attributed to it. Risk factors for melanoma include ultraviolet exposure, genetic predisposition, and phenotypic characteristics (eg, fair skin and blond hair). Whites have a 27-fold higher incidence of melanoma than African-Americans (AA), but the 5-year survival is 17.8% lower for AA than Whites. It is reported continuously that AA have more advanced melanomas at diagnosis, and overall lower survival rates. This minority melanoma paradox is not well understood or studied.

OBJECTIVE

To explore further, the possible explanations for the difference in melanoma severity and survival in AA within the US.

METHODS

Qualitative review of the literature.

RESULTS

Lack of minority-targeted public education campaigns, low self-risk perception, low self-skin examinations, intrinsic virulence, vitamin D differences, and physician mistrust may play a role in the melanoma survival disparity among AA.

CONCLUSION

Increases in public awareness of melanoma risk among AA through physician and media-guided education, higher index of suspicion among individuals and physicians, and policy changes can help to improve early detection and close the melanoma disparity gap in the future.

摘要

引言

黑色素瘤是最致命的皮肤癌类型,在美国,所有皮肤癌死亡病例中有75%归因于此。黑色素瘤的风险因素包括紫外线暴露、遗传易感性和表型特征(如白皙皮肤和金发)。白人患黑色素瘤的发病率比非裔美国人(AA)高27倍,但非裔美国人的5年生存率比白人低17.8%。不断有报道称,非裔美国人在诊断时黑色素瘤病情更严重,总体生存率更低。这种少数族裔黑色素瘤悖论尚未得到充分理解或研究。

目的

进一步探讨美国非裔美国人黑色素瘤严重程度和生存率差异的可能原因。

方法

对文献进行定性综述。

结果

缺乏针对少数族裔的公众教育活动、自我风险认知低、自我皮肤检查少、内在毒力、维生素D差异以及对医生的不信任,可能在非裔美国人黑色素瘤生存差异中起作用。

结论

通过医生和媒体引导的教育提高非裔美国人对黑色素瘤风险的公众意识、个人和医生提高怀疑指数以及政策改变,有助于在未来改善早期发现并缩小黑色素瘤差异差距。

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