Okobi Okelue E, Abreo Edelann, Sams Nneka P, Chukwuebuni Onyebuchi H, Tweneboa Amoako Loretta Agyemang, Wiredu Bernard, Uboh Emah E, Ekechi Victoria C, Okafor Adaku A
Family Medicine, Medficient Health Systems, Laurel, USA.
Family Medicine, Lakeside Medical Center, Belle Glade, USA.
Cureus. 2024 Oct 2;16(10):e70697. doi: 10.7759/cureus.70697. eCollection 2024 Oct.
Background and objectives Melanoma, a major skin cancer, has seen varying trends in incidence, prevalence, stage at diagnosis, and survival. This study examines these trends using the United States Cancer Statistics (USCS) database, covering the period from 1999 to 2021. Methods We extracted data from the USCS database, which integrates the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program and the Centers for Disease Control and Prevention's (CDC) National Program of Cancer Registries (NPCR). The analysis included new melanoma cases, prevalence estimates (using a 20-year limited duration), stage at diagnosis, and five-year relative survival rates. Incidence rates were adjusted for age using the 2000 United States standard population. Descriptive and trend analyses were performed using IBM SPSS Statistics software, version 29 (IBM Corp., Armonk, NY). Results The analysis of melanoma trends from 1999 to 2021 reveals a significant increase in the annual age-adjusted incidence rate, rising from 15.1 per 100,000 (95% CI: 14.9- 15.2) in 1999 to 23.0 per 100,000 (95% CI: 22.8- 23.1) in 2021. This upward trend is consistent across gender and racial/ethnic groups. The prevalence of melanoma over a 20-year period was 0.279 (95% CI: 0.276-0.282), with males showing a higher prevalence (0.302, 95% CI: 0.298-0.306) compared to females (0.256, 95% CI: 0.252-0.260). The distribution of melanoma stage at diagnosis indicated that 77% of cases were localized (95% CI: 76.5-77.5%), 9.5% regional (95% CI: 9.2-9.8%), 4.7% distant (95% CI: 4.4-5.0%), and 8.8% unstaged (95% CI: 8.5-9.1%). Survival analysis showed a five-year relative survival rate of 99.4% (95% CI: 99.2-99.6%) for localized melanoma and 35.6% (95% CI: 33.7-37.6%) for distant melanoma, highlighting significant disparities in survival based on stage at diagnosis. Conclusions The study highlights a rising incidence of melanoma and emphasizes the critical role of early detection in improving survival outcomes. The findings underscore the effectiveness of early diagnosis and the necessity for ongoing efforts to improve melanoma outcomes across diverse populations.
背景与目的 黑色素瘤是一种主要的皮肤癌,其发病率、患病率、诊断时的分期以及生存率呈现出不同的趋势。本研究利用美国癌症统计(USCS)数据库对这些趋势进行了考察,该数据库涵盖了1999年至2021年这一时期。方法 我们从USCS数据库中提取数据,该数据库整合了美国国立癌症研究所(NCI)的监测、流行病学和最终结果(SEER)计划以及疾病控制与预防中心(CDC)的国家癌症登记计划(NPCR)。分析内容包括新发黑色素瘤病例、患病率估计(采用20年有限期限)、诊断时的分期以及五年相对生存率。发病率使用2000年美国标准人口进行年龄调整。使用IBM SPSS Statistics软件29版(IBM公司,纽约州阿蒙克)进行描述性分析和趋势分析。结果 对1999年至2021年黑色素瘤趋势的分析显示,年龄调整后的年发病率显著上升,从1999年的每10万人15.1例(95%CI:14.9 - 15.2)升至2021年的每10万人23.0例(95%CI:22.8 - 23.1)。这种上升趋势在性别和种族/族裔群体中是一致的。20年期间黑色素瘤的患病率为0.279(95%CI:0.276 - 0.282),男性患病率(0.302,95%CI:0.298 - 0.306)高于女性(0.256,95%CI:0.252 - 0.260)。诊断时黑色素瘤分期的分布表明,77%的病例为局限性(95%CI:76.5 - 77.5%),9.5%为区域性(95%CI:9.2 - 9.8%),4.7%为远处转移(95%CI:4.4 - 5.0%),8.8%为未分期(95%CI:8.5 - 9.1%)。生存分析显示,局限性黑色素瘤的五年相对生存率为99.4%(95%CI:99.2 - 99.6%),远处转移黑色素瘤的五年相对生存率为35.6%(95%CI:33.7 - 37.6%),突出了基于诊断时分期的生存显著差异。结论 该研究突出了黑色素瘤发病率的上升,并强调了早期检测在改善生存结局方面的关键作用。研究结果强调了早期诊断的有效性以及持续努力改善不同人群黑色素瘤结局的必要性。