Tripp Mary K, Watson Meg, Balk Sophie J, Swetter Susan M, Gershenwald Jeffrey E
Instructor, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX.
Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA.
CA Cancer J Clin. 2016 Nov 12;66(6):460-480. doi: 10.3322/caac.21352. Epub 2016 May 27.
Answer questions and earn CME/CNE Although overall cancer incidence rates are decreasing, melanoma incidence rates continue to increase about 3% annually. Melanoma is a significant public health problem that exacts a substantial financial burden. Years of potential life lost from melanoma deaths contribute to the social, economic, and human toll of this disease. However, most cases are potentially preventable. Research has clearly established that exposure to ultraviolet radiation increases melanoma risk. Unprecedented antitumor activity and evolving survival benefit from novel targeted therapies and immunotherapies are now available for patients with unresectable and/or metastatic melanoma. Still, prevention (minimizing sun exposure that may result in tanned or sunburned skin and avoiding indoor tanning) and early detection (identifying lesions before they become invasive or at an earlier stage) have significant potential to reduce melanoma incidence and melanoma-associated deaths. This article reviews the state of the science on prevention and early detection of melanoma and current areas of scientific uncertainty and ongoing debate. The US Surgeon General's Call to Action to Prevent Skin Cancer and US Preventive Services Task Force reviews on skin cancer have propelled a national discussion on melanoma prevention and screening that makes this an extraordinary and exciting time for diverse disciplines in multiple sectors-health care, government, education, business, advocacy, and community-to coordinate efforts and leverage existing knowledge to make major strides in reducing the public health burden of melanoma in the United States. CA Cancer J Clin 2016;66:460-480. © 2016 American Cancer Society.
回答问题并获得继续医学教育/继续护理教育学分 尽管总体癌症发病率在下降,但黑色素瘤的发病率仍以每年约3%的速度持续上升。黑色素瘤是一个重大的公共卫生问题,造成了巨大的经济负担。黑色素瘤死亡导致的潜在寿命损失年数加剧了这种疾病对社会、经济和人类的损害。然而,大多数病例是可以预防的。研究已明确表明,暴露于紫外线辐射会增加患黑色素瘤的风险。对于不可切除和/或转移性黑色素瘤患者,新型靶向疗法和免疫疗法展现出了前所未有的抗肿瘤活性,并不断带来生存获益。尽管如此,预防(尽量减少可能导致皮肤晒黑或晒伤的阳光暴露并避免室内晒黑)和早期检测(在病变变得侵袭性或处于更早阶段之前识别病变)仍有很大潜力降低黑色素瘤发病率和与黑色素瘤相关的死亡。本文综述了黑色素瘤预防和早期检测的科学现状以及当前存在科学不确定性和持续争论的领域。美国卫生局局长预防皮肤癌行动呼吁以及美国预防服务工作组对皮肤癌的综述推动了一场关于黑色素瘤预防和筛查的全国性讨论,这使得当前成为医疗保健、政府、教育、商业、宣传和社区等多个部门的不同学科协调努力并利用现有知识在美国减轻黑色素瘤公共卫生负担方面取得重大进展的非凡而激动人心的时刻。《CA:临床肿瘤学杂志》2016年;66:460 - 480。© 2016美国癌症协会