Kamath Sonia, Miller Kimberly A, Cockburn Myles G
Department of Dermatology, Keck School of Medicine of the University of Southern California (USC), 1200 N State Street, Room 3250, Los Angeles, CA 90033, USA.
Department of Preventive Medicine, Keck School of Medicine of USC, 2001 N. Soto Street, Suite 318-A, Los Angeles, CA 90032, USA.
J Skin Cancer. 2016;2016:2105250. doi: 10.1155/2016/2105250. Epub 2016 Mar 22.
United States Hispanics have seven times lower melanoma incidence rates than non-Hispanic whites (NHW). It is unclear whether this difference can be explained solely by phenotypic risk factors, like darker skin, or whether modifiable risk factors, like sun exposure, also play a role. The purpose of this paper is to summarize what is currently known about melanoma risk factors among Hispanics and NHWs, and whether or not those differences could explain the difference in melanoma incidence. Through literature review, relative risks and prevalence of melanoma risk factors in Hispanics and NHWs were identified and used to calculate the expected rate in Hispanics and rate ratio compared to NHWs. We found that melanoma risk factors either have similar frequency in Hispanics and NHWs (e.g., many large nevi) or are less frequent in Hispanics but do not explain a high proportion of disease variation (e.g., red hair). Considering current knowledge of risk factor prevalence, we found that melanoma incidence rates in the two groups should actually be similar. Sun exposure behavior among Hispanics may contribute to the explanation for the 7-fold difference in melanoma rates. Currently, limited data exist on sun exposure behavior among Hispanics, but possibilities for improving primary prevention by further studying these practices are substantial.
美国西班牙裔的黑色素瘤发病率比非西班牙裔白人（NHW）低7倍。目前尚不清楚这种差异是否仅可由表型风险因素（如肤色较深）来解释，还是可改变的风险因素（如日晒）也起作用。本文的目的是总结目前已知的西班牙裔和非西班牙裔白人中黑色素瘤风险因素的情况，以及这些差异是否能解释黑色素瘤发病率的差异。通过文献综述，确定了西班牙裔和非西班牙裔白人中黑色素瘤风险因素的相对风险和患病率，并用于计算西班牙裔的预期发病率以及与非西班牙裔白人相比的发病率比值。我们发现，黑色素瘤风险因素在西班牙裔和非西班牙裔白人中的出现频率要么相似（如许多大痣），要么在西班牙裔中出现频率较低，但不能解释很大比例的疾病差异（如红发）。考虑到目前对风险因素患病率的了解，我们发现两组的黑色素瘤发病率实际上应该相似。西班牙裔的日晒行为可能有助于解释黑色素瘤发病率7倍的差异。目前，关于西班牙裔日晒行为的数据有限，但通过进一步研究这些行为来改善一级预防的可能性很大。
