Karimkhani C, Green A C, Nijsten T, Weinstock M A, Dellavalle R P, Naghavi M, Fitzmaurice C
Department of Dermatology, University of Colorado, Aurora, CO, U.S.A.
QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
Br J Dermatol. 2017 Jul;177(1):134-140. doi: 10.1111/bjd.15510. Epub 2017 Jun 12.
Despite recent improvements in prevention, diagnosis and treatment, vast differences in melanoma burden still exist between populations. Comparative data can highlight these differences and lead to focused efforts to reduce the burden of melanoma.
To assess global, regional and national melanoma incidence, mortality and disability-adjusted life year (DALY) estimates from the Global Burden of Disease Study 2015.
Vital registration system and cancer registry data were used for melanoma mortality modelling. Incidence and prevalence were estimated using separately modelled mortality-to-incidence ratios. Total prevalence was divided into four disease phases and multiplied by disability weights to generate years lived with disability (YLDs). Deaths in each age group were multiplied by the reference life expectancy to generate years of life lost (YLLs). YLDs and YLLs were added to estimate DALYs.
The five world regions with the greatest melanoma incidence, DALY and mortality rates were Australasia, North America, Eastern Europe, Western Europe and Central Europe. With the exception of regions in sub-Saharan Africa, DALY and mortality rates were greater in men than in women. DALY rate by age was highest in those aged 75-79 years, 70-74 years and ≥ 80 years.
The greatest burden from melanoma falls on Australasian, North American, European, elderly and male populations, which is consistent with previous investigations. These substantial disparities in melanoma burden worldwide highlight the need for aggressive prevention efforts. The Global Burden of Disease Study results can help shape melanoma research and public policy.
尽管近期在预防、诊断和治疗方面有所改善,但不同人群之间的黑色素瘤负担仍存在巨大差异。比较数据可以凸显这些差异,并促使人们集中精力减轻黑色素瘤负担。
评估《2015年全球疾病负担研究》中全球、区域和国家层面的黑色素瘤发病率、死亡率及伤残调整生命年(DALY)估计值。
利用生命登记系统和癌症登记数据进行黑色素瘤死亡率建模。发病率和患病率通过分别建模的死亡率与发病率之比进行估计。总患病率被分为四个疾病阶段,并乘以伤残权重以生成失能生存年数(YLD)。每个年龄组的死亡人数乘以参考预期寿命以生成寿命损失年数(YLL)。将YLD和YLL相加以估计DALY。
黑色素瘤发病率、DALY和死亡率最高的五个世界区域是澳大拉西亚、北美、东欧、西欧和中欧。除撒哈拉以南非洲地区外,男性的DALY和死亡率高于女性。按年龄划分的DALY率在75 - 79岁、70 - 74岁和80岁及以上人群中最高。
黑色素瘤负担最重的是澳大拉西亚、北美、欧洲、老年和男性人群,这与先前的调查结果一致。全球范围内黑色素瘤负担的这些巨大差异凸显了积极预防工作的必要性。全球疾病负担研究结果有助于指导黑色素瘤研究和公共政策。