Conte Santina, Ghazawi Feras M, Le Michelle, Nedjar Hacene, Alakel Akram, Lagacé François, Mukovozov Ilya M, Cyr Janelle, Mourad Ahmed, Miller Wilson H, Claveau Joël, Salopek Thomas G, Netchiporouk Elena, Gniadecki Robert, Sasseville Denis, Rahme Elham, Litvinov Ivan V
Faculty of Medicine, McGill University, Montréal, QC, Canada.
Division of Dermatology, University of Ottawa, Ottawa, ON, Canada.
Front Med (Lausanne). 2022 Mar 3;9:830254. doi: 10.3389/fmed.2022.830254. eCollection 2022.
Cutaneous melanoma (CM) is one of the most fatal types of skin cancer. Alarmingly, increases in incidence and mortality were noted globally for this malignancy, despite increase in understanding of melanoma pathogenesis and enhanced prevention efforts.
Data was extracted for CM patients for provinces and territories (except Quebec) using two independent, population-based registries. Analysis was performed using both clinical and pathological characteristics: tumor morphologic classification, age, sex, anatomic site affected and place of residence. Mortality trends were assessed over a 7-year period. Results were compared to prior findings for 1992-2010.
During 2011-2017 39,610 patients were diagnosed with CM, with 5,890 reported deaths. National crude CM incidence was 20.75 (age-standardized incidence: 14.12) cases per 100,000 individuals per year. Females accounted for 45.8% of cases and 37.1% of deaths. While CM incidence rates continue to increase in both sexes, since 2013 the CM mortality is declining. We observed important differences across the provinces/territories, where Nova Scotia, Prince Edward Island, southern Ontario/British Columbia and certain coastal communities of New Brunswick demonstrated higher CM incidence and mortality rates. The observed incidence and mortality trends for 2011-2017 validate and extend earlier observations from 1992 to 2010 for CM.
This population-based study highlights that while melanoma's incidence is increasing in Canada, mortality rates are for the first time decreasing since 2013. We detail regional distribution of this cancer highlighting communities in southern/coastal areas, as being most at risk as well as the latest trends of melanoma incidence by age, sex and anatomic site. In males, melanoma is more common on the head/trunk, while in females on the extremities. Notably, Acral Lentiginous Melanoma was the only CM subtype that was more common in females, which primarily affects hands and feet.
皮肤黑色素瘤（CM）是最致命的皮肤癌类型之一。令人担忧的是，尽管对黑色素瘤发病机制的认识有所提高且预防力度加大，但全球范围内这种恶性肿瘤的发病率和死亡率仍在上升。
利用两个独立的基于人群的登记系统，提取了加拿大各省和地区（魁北克除外）CM患者的数据。分析采用临床和病理特征：肿瘤形态学分类、年龄、性别、受累解剖部位和居住地。评估了7年期间的死亡率趋势。结果与1992 - 2010年的先前研究结果进行了比较。
在2011 - 2017年期间，39,610例患者被诊断为CM，报告死亡5,890例。全国CM粗发病率为每年每10万人20.75例（年龄标准化发病率：14.12例）。女性占病例的45.8%，占死亡的37.1%。虽然CM发病率在两性中持续上升，但自2013年以来CM死亡率在下降。我们观察到各省/地区之间存在重要差异，新斯科舍省、爱德华王子岛、安大略省南部/不列颠哥伦比亚省以及新不伦瑞克省的某些沿海社区CM发病率和死亡率较高。2011 - 2017年观察到的发病率和死亡率趋势验证并扩展了1992年至2010年CM的早期观察结果。
这项基于人群的研究强调，虽然加拿大黑色素瘤的发病率在上升，但自2013年以来死亡率首次下降。我们详细说明了这种癌症的区域分布，突出了南部/沿海地区的社区风险最高，以及按年龄、性别和解剖部位划分的黑色素瘤发病率的最新趋势。在男性中，黑色素瘤在头部/躯干更常见，而在女性中在四肢更常见。值得注意的是，肢端雀斑样痣黑色素瘤是唯一在女性中更常见的CM亚型，主要影响手和脚。
