Hübner J, Waldmann A, Geller A C, Weinstock M A, Eisemann N, Noftz M, Bertram S, Nolte S, Volkmer B, Greinert R, Breitbart E, Katalinic A
Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck 23562, Germany.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Br J Cancer. 2017 Jan 17;116(2):253-259. doi: 10.1038/bjc.2016.390. Epub 2016 Nov 29.
The rate of interval cancers is an established indicator for the performance of a cancer-screening programme.
We examined the incidence, tumour characteristics and risk factors of melanoma interval cancers that occurred in participants of the SCREEN project, which was carried out 2003/2004 in Schleswig-Holstein, Germany. Data from 350 306 SCREEN participants, who had been screened negative for melanoma, were linked to data of the state cancer registry. Melanoma interval cancers were defined as melanomas diagnosed within 4-24 months after SCREEN examination. Results were compared with melanomas of the pre-SCREEN era (1999-2002), extracted from the cancer registry.
The overall relative incidence of melanoma interval cancers in terms of observed/expected ratio was 0.93 (95% CI: 0.82-1.05; in situ: 1.61 (1.32-1.95), invasive: 0.71 (0.60-0.84)). Compared with melanomas of the pre-SCREEN era, the interval melanomas were thinner and had a slightly greater proportion of lentigo maligna melanomas whereas nodular melanomas were less frequent.
The results indicate a moderate performance of the SCREEN intervention with an excess of in situ melanomas. In part, the findings might be due to specifics of the SCREEN project, in particular a short-term follow-up of patients at high risk for melanoma.
间期癌发生率是癌症筛查项目实施效果的既定指标。
我们研究了2003/2004年在德国石勒苏益格－荷尔斯泰因州开展的“筛查”（SCREEN）项目参与者中发生的黑色素瘤间期癌的发病率、肿瘤特征和风险因素。350306名黑色素瘤筛查结果为阴性的“筛查”项目参与者的数据与该州癌症登记处的数据相关联。黑色素瘤间期癌定义为在“筛查”检查后4至24个月内诊断出的黑色素瘤。将结果与从癌症登记处提取的“筛查”前时代（1999 - 2002年）的黑色素瘤进行比较。
黑色素瘤间期癌的总体相对发病率（观察值/预期值比）为0.93（95%置信区间：0.82 - 1.05；原位癌：1.61（1.32 - 1.95），浸润性癌：0.71（0.60 - 0.84））。与“筛查”前时代的黑色素瘤相比，间期黑色素瘤更薄，恶性雀斑样痣黑色素瘤的比例略高，而结节性黑色素瘤的发生率较低。
结果表明“筛查”干预效果中等，原位黑色素瘤过多。部分研究结果可能归因于“筛查”项目的特殊性，特别是对黑色素瘤高危患者的短期随访。
