Collier V, Musicante M, Patel T, Liu-Smith F
Kaplan-Amonette Department of Dermatology The University of Tennessee Health Science Center Memphis Tennessee USA.
College of Medicine University of Tennessee Health Science Center Memphis Tennessee USA.
Skin Health Dis. 2021 Apr 1;1(2):e27. doi: 10.1002/ski2.27. eCollection 2021 Jun.
Sex or gender disparity in skin cancer has been documented for a long time at the population level. UV radiation (UVR) is a common environmental risk for all three major types of skin cancer: cutaneous melanoma (CM), basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC). The underlying mechanism for sex disparity has been largely attributed to sex-differentiated behaviour patterns related to UVR. Non-UVR factors such as intrinsic physiological differences have been suggested but remain understudied.
This review summarizes and compares the known sex differences in three skin cancer types with regard to body site distribution and age influence.
We found a similar age-dependent sex difference pattern in CM and BCC. Specifically, CM and BCC tend to show higher incidence in young women and old men, with a switching age around menopause. The switching age suggests involvement of sex hormones, which has shown controversial influence on skin cancers at epidemiological level. Literatures regarding sex hormone receptors for oestrogen, androgen and progesterone are summarized for potential explanations at molecular level.
Overall, more and more evidence suggests non-UVR factors such as sex hormones play critical roles in skin cancer (especially CM and BCC), yet solid population and molecular evidence are required. Incidences of skin cancer are increasing which suggests limited effect for the current UVR-avoidance prevention methods.
Fully understanding the causes of sex disparities in incidence is necessary for developing a comprehensive prevention strategy.
长期以来，在人群层面已证实皮肤癌存在性别差异。紫外线辐射（UVR）是所有三种主要皮肤癌类型的常见环境风险因素，这三种皮肤癌分别是皮肤黑色素瘤（CM）、基底细胞癌（BCC）和皮肤鳞状细胞癌（cSCC）。性别差异的潜在机制在很大程度上归因于与紫外线辐射相关的性别分化行为模式。虽然有人提出诸如内在生理差异等非紫外线辐射因素，但仍研究不足。
目的、材料与方法：本综述总结并比较了三种皮肤癌类型在身体部位分布和年龄影响方面已知的性别差异。
我们在皮肤黑色素瘤和基底细胞癌中发现了类似的年龄依赖性性别差异模式。具体而言，皮肤黑色素瘤和基底细胞癌在年轻女性和老年男性中往往发病率较高，转变年龄在绝经前后。这一转变年龄表明性激素参与其中，而性激素在流行病学层面已显示出对皮肤癌存在有争议的影响。我们总结了有关雌激素、雄激素和孕激素性激素受体的文献，以便在分子水平进行潜在解释。
总体而言，越来越多的证据表明性激素等非紫外线辐射因素在皮肤癌（尤其是皮肤黑色素瘤和基底细胞癌）中起关键作用，但仍需要确凿的人群和分子证据。皮肤癌发病率在上升，这表明当前的紫外线辐射避免预防方法效果有限。
全面了解发病率性别差异的原因对于制定全面的预防策略至关重要。
