Public Health & Preventive Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.
J Eur Acad Dermatol Venereol. 2019 Aug;33(8):1522-1528. doi: 10.1111/jdv.15565. Epub 2019 Apr 3.
Mortality from malignant cutaneous melanoma increased alarmingly during the second half of the 20th century in Spain and other European countries.
The aim was to analyse sex- and age-specific trends in melanoma mortality in Spain in the period 1982-2016.
European age-standardized melanoma mortality rates during the period 1982-2016 were calculated from mortality figures provided by the National Statistics Institute. Joinpoint regressions were used to identify significant points of change in trends and to compute average annual per cent change (AAPC). Age-cohort-period models were fitted to explore the effect of these variables on mortality.
During the period 1982-2016, age-standardized melanoma mortality rates increased in Spain from 0.90 to 1.80 deaths per 100 000 people in men and from 0.64 to 1.11 per 100 000 in women, rising noticeably from 1982 to 1995 in both sexes and in all age groups. From the mid-90s different trends were observed depending on sex and age: there was a decrease in mortality in the population younger than 45 years (AAPC -2 in both sexes) and aged 45-64 years (AAPC -1 among men and -0.2 among women), but in the group over 64 years rates continued to increase (AAPC 1.7 and 0.2, respectively, for men and women). The mortality sex ratio decreased in the younger population but increased in older individuals. A cohort effect was observed with lower mortality in the cohorts born after 1943 in men and 1956 in women. There was also a period effect with decreased mortality rates at the beginning of the 1990s.
Melanoma mortality rates in Spain increased during the last decades of the 20th century; however, later they stabilized in women and began to decrease in younger cohorts and middle-aged men. Promotion of primary and secondary prevention measures should continue, with particular emphasis on males over 65 years.
在 20 世纪后半叶，西班牙和其他欧洲国家的恶性皮肤黑色素瘤死亡率惊人地上升。
分析 1982 年至 2016 年期间西班牙黑色素瘤死亡率的性别和年龄特异性趋势。
从国家统计局提供的死亡率数据中计算出 1982 年至 2016 年期间的欧洲年龄标准化黑色素瘤死亡率。使用 Joinpoint 回归来确定趋势变化的显著转折点，并计算平均年百分比变化（AAPC）。拟合年龄-队列-时期模型，以探讨这些变量对死亡率的影响。
在 1982 年至 2016 年期间，西班牙男性的年龄标准化黑色素瘤死亡率从 0.90 增加到 1.80 人/每 100,000 人，女性从 0.64 增加到 1.11 人/每 100,000 人，在两性和所有年龄组中，从 1982 年到 1995 年显著上升。从 90 年代中期开始，根据性别和年龄观察到不同的趋势：在 45 岁以下人群（两性 AAPC 分别为-2）和 45-64 岁人群（男性 AAPC-1，女性 AAPC-0.2）中死亡率下降，但在 64 岁以上人群中，死亡率继续上升（男性和女性分别为 AAPC 1.7 和 0.2）。年轻人群中的性别比例下降，但老年人群中的性别比例上升。观察到队列效应，男性出生于 1943 年以后的队列和女性出生于 1956 年以后的队列的死亡率较低。还观察到时期效应，90 年代初死亡率下降。
西班牙的黑色素瘤死亡率在 20 世纪最后几十年有所上升；然而，后来在女性中稳定下来，在年轻队列和中年男性中开始下降。应继续促进初级和二级预防措施，特别是对 65 岁以上的男性。
