Department of Family Medicine, McGill University, Montreal, Québec, Canada.
Independent Consultant, MGIS, Ottawa, Ontario, Canada.
Dermatology. 2022;238(6):1006-1017. doi: 10.1159/000524949. Epub 2022 Jun 9.
Over 90% of skin cancers including cutaneous melanoma (CM) are related directly to sun exposure. Despite extensive knowledge on ultraviolet radiation's (UVR) detrimental impact, many still fail to implement sun protection/sun avoidance. Human behavior, attitudes, and cultural norms of individuals and communities heavily depend on the surrounding climate/environment. In many instances, the climate shapes the culture/norms of the society. Canada has vast geographic/environmental differences.
In the current ecological study, we sought to examine the relationship between various geographic and environmental factors and the distribution of CM incidence by Forward Sortation Area (FSA) postal code across Canada. CM incidence data were extracted from the Canadian Cancer Registry, while environmental data were extracted from the Canadian Urban Environmental Health Research Consortium (greenspace, as measured by the normalized difference vegetation index; annual highest temperature; absolute number and average length of yearly heat events; annual total precipitation [rain and snow]; absolute number and average length of events with precipitation [rain and snow]; and summer UVR index). The above geographic/environmental data by FSA were correlated with the respective CM incidence employing negative binomial regression model.
Our analysis highlights that increases in annual average temperature, summer UVR, and greenspace were associated with higher expected incidence of CM cases, while higher number of annual heat events together with highest annual temperature and higher average number of annual rain events were associated with a decrease in CM incidence rate. This study also highlights regional variation in environmental CM risk factors in Canada.
This national population-based study presents clinically relevant conclusions on weather/geographic variations associated with CM incidence in Canada and will help refine targeted CM prevention campaigns by understanding unique weather/geographic variations in high-risk regions.
超过 90%的皮肤癌，包括皮肤黑色素瘤（CM），直接与阳光暴露有关。尽管人们对紫外线辐射（UVR）的有害影响有广泛的了解，但许多人仍然未能实施防晒/避免阳光照射。个人和社区的行为、态度和文化规范在很大程度上取决于周围的气候/环境。在许多情况下，气候塑造了社会的文化/规范。加拿大拥有广阔的地理/环境差异。
在当前的生态研究中，我们试图通过加拿大各地的邮政编码（Forward Sortation Area，FSA）来检查各种地理和环境因素与 CM 发病率分布之间的关系。CM 发病率数据从加拿大癌症登记处提取，而环境数据从加拿大城市环境健康研究联合会（绿地，用归一化差异植被指数衡量；年最高温度；每年热事件的绝对数量和平均长度；年总降水量[雨和雪]；有降水[雨和雪]的事件的绝对数量和平均长度；夏季紫外线辐射指数）提取。通过 FSA 获得的上述地理/环境数据与各自的 CM 发病率采用负二项回归模型进行相关分析。
我们的分析强调，年平均温度、夏季紫外线辐射和绿地的增加与 CM 病例预期发病率的增加有关，而每年热事件的数量增加、年最高温度和年平均降水量的增加与 CM 发病率的下降有关。这项研究还突出了加拿大环境 CM 危险因素的区域差异。
这项基于全国人口的研究提供了有关加拿大 CM 发病率与天气/地理变化相关的临床相关结论，并通过了解高风险地区独特的天气/地理变化，有助于完善针对 CM 的预防活动。
