Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
J Eur Acad Dermatol Venereol. 2018 Nov;32(11):1906-1913. doi: 10.1111/jdv.14990. Epub 2018 Jul 17.
Skin cancer being the most common cancer in Germany has shown increasing incidence in the past decade. Since mostly caused by excessive UV exposure, skin cancer is largely related to behaviour. So far, the impact of regional and sociodemographic factors on the development of skin cancer in Germany is unclear.
This study aimed to investigate the association of potential predictive factors with the prevalence of skin cancers in Germany.
Nationwide ambulatory care claims data from persons insured in statutory health insurances (SHI) with malignant melanoma (MM, ICD-10 C43) and non-melanocytic skin cancer (NMSC, ICD-10 C44) in the years 2009-2015 were analysed. In addition, sociodemographic population data and satellite-based UV and solar radiation data were associated. Descriptive and multivariate (spatial) statistical analyses (e.g. Bayes' smoothing) were conducted on county level.
Data from 70.1 million insured persons were analysed. Age-standardized prevalences per 100 000 SHI insured persons for MM and NMSC were 284.7 and 1126.9 in 2009 and 378.5 and 1708.2 in 2015. Marked regional variations were observed with prevalences between 32.9% and 51.6%. Multivariate analysis shows among others statistically significant positive correlations between higher income and education, and MM/NMSC prevalence.
Prevalence of MM and NMSC in Germany shows spatio-temporal dynamics. Our results demonstrate that regional UV radiation, sunshine hours and sociodemographic factors have significant impact on skin cancer prevalence in Germany. Individual behaviour obviously is a major determinant which should be subject to preventive interventions.
皮肤癌是德国最常见的癌症，在过去十年中发病率不断上升。由于皮肤癌主要是由过度的紫外线暴露引起的，因此与行为有很大关系。到目前为止，区域和社会人口因素对德国皮肤癌发展的影响尚不清楚。
本研究旨在探讨潜在预测因素与德国皮肤癌患病率之间的关联。
分析了 2009 年至 2015 年间，法定健康保险（SHI）参保人员中恶性黑色素瘤（MM，ICD-10 C43）和非黑素细胞性皮肤癌（NMSC，ICD-10 C44）的全国门诊护理索赔数据。此外，还将社会人口数据与基于卫星的紫外线和太阳辐射数据相关联。在县级进行描述性和多变量（空间）统计分析（例如贝叶斯平滑）。
分析了 7010 万参保人员的数据。2009 年和 2015 年，每 10 万 SHI 参保人员中 MM 和 NMSC 的年龄标准化患病率分别为 284.7 和 1126.9，378.5 和 1708.2。观察到明显的区域差异，患病率在 32.9%至 51.6%之间。多变量分析显示，收入和教育水平较高等因素与 MM/NMSC 患病率呈正相关。
德国 MM 和 NMSC 的患病率呈现时空动态。我们的研究结果表明，区域紫外线辐射、日照时间和社会人口因素对德国皮肤癌患病率有显著影响。个体行为显然是一个主要决定因素，应该成为预防干预的对象。
