Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Dermatology, VA Integrated Service Network (VISN-1), Jamaica Plain, Massachusetts.
Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Jamaica Plain, Massachusetts.
J Am Acad Dermatol. 2022 Jul;87(1):72-79. doi: 10.1016/j.jaad.2022.02.063. Epub 2022 May 17.
The Surveillance, Epidemiology, and End Results (SEER) program reflects a third of the population of the United States. However, SEER may not be generalizable to the veteran population. Because veterans comprise a high-risk population, this discrepancy may limit our understanding of the epidemiology of melanoma in such high-risk populations.
To assess differences in demographics, tumor characteristics, and melanoma-specific survival (MSS) in veterans compared to the general population.
Data were collected from the Veterans Affairs Cancer Registry (VACR) and SEER (18 registries) from 2009 to 2017.
We identified 15,334 veterans and 166,265 SEER patients with melanoma. Veterans were more likely to present with regional or distant disease (17.5% vs 13.0% in SEER). In VACR relative to SEER, the 5-year MSS was lower across all ages, except those diagnosed at ≥80 years. From 2009 to 2017, MSS by stage was lower across all stages in VACR. However, for stage IV melanomas diagnosed in 2015 to 2017 compared to 2011-2014, 2-year MSS increased from 37.8% to 51.5% in VACR versus 36.4% to 44.8% in SEER.
Unique veteran demographics and missing data inherent to VACR.
Compared to SEER, veterans with melanoma were diagnosed at later stages; however, both exhibited recent improvement in stage IV MSS.
监测、流行病学和最终结果（SEER）计划反映了美国三分之一的人口。然而，SEER 可能不适用于退伍军人群体。由于退伍军人是高危人群，这种差异可能会限制我们对这类高危人群中黑色素瘤的流行病学的理解。
评估退伍军人与普通人群相比在人口统计学、肿瘤特征和黑色素瘤特异性生存（MSS）方面的差异。
数据来自退伍军人事务部癌症登记处（VACR）和 SEER（18 个登记处），时间为 2009 年至 2017 年。
我们确定了 15334 名退伍军人和 166265 名 SEER 黑色素瘤患者。退伍军人更有可能出现局部或远处疾病（VACR 中为 17.5%，SEER 中为 13.0%）。与 SEER 相比，VACR 中所有年龄段的 5 年 MSS 均较低，但≥80 岁诊断的患者除外。2009 年至 2017 年，VACR 中所有分期的 MSS 均低于所有分期。然而，对于 2015 年至 2017 年诊断的 IV 期黑色素瘤，与 2011-2014 年相比，VACR 中的 2 年 MSS 从 37.8%增加到 51.5%，而 SEER 中的 2 年 MSS 从 36.4%增加到 44.8%。
VACR 特有的独特退伍军人人口统计学和缺失数据。
与 SEER 相比，退伍军人黑色素瘤的诊断分期较晚；然而，两者的 IV 期 MSS 近期均有所改善。
