荷兰基于人群队列中首次黑色素瘤、鳞状细胞癌和基底细胞癌后不同皮肤肿瘤组合的风险：1989-2009 年。

Risks of different skin tumour combinations after a first melanoma, squamous cell carcinoma and basal cell carcinoma in Dutch population-based cohorts: 1989-2009.

机构信息

Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.

Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.

出版信息

J Eur Acad Dermatol Venereol. 2018 Mar;32(3):382-389. doi: 10.1111/jdv.14587. Epub 2017 Oct 17.

DOI:10.1111/jdv.14587

PMID:28898461

Abstract

BACKGROUND

Skin cancer patients are primarily at increased risk of developing subsequent skin cancers of the same type. Shared risk factors might also increase the occurrence of a different type of subsequent skin cancer.

OBJECTIVE

To investigate risks of different skin tumour combinations after a first melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).

METHODS

All melanoma and SCC patients included in the national Netherlands Cancer Registry (NCR) and all BCC patients included in the regional Eindhoven Cancer Registry (ECR) between 1989 and 2009 were followed until diagnosis of a subsequent different skin cancer (melanoma, SCC or BCC), date of death or end of study. Cumulative risks, standardized incidence ratios (SIR) and absolute excess risks (AER) of subsequent skin cancers were calculated.

RESULTS

A total of 50 510 melanoma patients and 64 054 patients with a SCC of the skin were included (national data NCR). The regional data of the ECR consisted of 5776 melanoma patients, 5749 SCC patients and 41 485 BCC patients. The 21-year cumulative risk for a subsequent melanoma after a first SCC or BCC was respectively 1.7% and 1.3% for males and 1.3% and 1.2% for females; SCC after melanoma or BCC was 4.6% and 9.3% (males) and 2.6% and 4.1% (females); BCC after melanoma or SCC was respectively 13.2% and 27.8% (males) and 14.9% and 21.1% (females). SIRs and AERs remained elevated up to 21 years after the first melanoma, SCC or BCC.

CONCLUSION

This large population-based study investigating risks of developing a different subsequent cutaneous malignancy showed high-cumulative risks of mainly KC and markedly increased relative and absolute risks of all tumour combinations. These estimates confirm a common carcinogenesis and can serve as a base for follow-up guidelines and patient education aiming for an early detection of the subsequent cancers.

摘要

背景

皮肤癌患者主要面临着相同类型的后续皮肤癌的风险增加。共同的风险因素也可能增加不同类型的后续皮肤癌的发生。

目的

研究首次黑色素瘤、鳞状细胞癌（SCC）和基底细胞癌（BCC）后不同皮肤肿瘤组合的风险。

方法

1989 年至 2009 年间，全国荷兰癌症登记处（NCR）纳入的所有黑色素瘤和 SCC 患者以及区域艾恩德霍芬癌症登记处（ECR）纳入的所有 BCC 患者均接受随访，直至诊断出另一种不同的皮肤癌（黑色素瘤、SCC 或 BCC）、死亡或研究结束。计算了后续皮肤癌的累积风险、标准化发病比（SIR）和绝对超额风险（AER）。

结果

共纳入 50510 例黑色素瘤患者和 64054 例皮肤 SCC 患者（国家数据 NCR）。ECR 的区域数据包括 5776 例黑色素瘤患者、5749 例 SCC 患者和 41485 例 BCC 患者。男性首次 SCC 或 BCC 后 21 年累积风险分别为 1.7%和 1.3%，女性为 1.3%和 1.2%；黑色素瘤后 SCC 为 4.6%和 9.3%（男性）和 2.6%和 4.1%（女性）；黑色素瘤后 BCC 为 13.2%和 27.8%（男性）和 14.9%和 21.1%（女性）。SIR 和 AER 仍在首次黑色素瘤、SCC 或 BCC 后 21 年内升高。