Wang Xingyue M, Borsky Kim, Proctor Dominic W, Goodall Richard, Marshall Dominic C, Dobell William, Salciccioli Justin D, Matin Rubeta N, Shalhoub Joseph, El-Muttardi Naguib
Royal Marsden Hospital NHS Foundation Trust, Surrey, UK.
Medical Data Research Collaborative, London, UK.
J Eur Acad Dermatol Venereol. 2025 Jul;39(7):1285-1296. doi: 10.1111/jdv.20524. Epub 2025 Jan 8.
Cutaneous melanoma (CM) is the leading cause of skin cancer mortality with associated high healthcare costs. Up-to-date reporting of epidemiological trends for CM is required to project future trends, assess the burden of disease and aid evaluation of new diagnostic, therapeutic and preventative strategies.
To describe the trends in CM mortality, incidence, mortality-to-incidence indices (MIIs) and disability-adjusted life years (DALYs) over the last three decades.
A population-based cross-sectional study of the Global Burden of Disease (GBD) database between 1990 and 2019 was performed. Nineteen high-income countries with similar health expenditure and classified as having high-quality mortality data including the United Kingdom, the United States, Australia and selected European Union countries were included. Annual age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs) and DALYs for each country were extracted. Mortality-to-incidence indexes were calculated by dividing the ASDR by the ASIR. Trends were described using Joinpoint regression analysis.
Almost all countries demonstrated increasing ASDR in males over the observation period with greatest percentage increase in Greece (+87%), and there was greater heterogeneity between countries in females. CM mortality was greater for males than females in all countries. Most recent Joinpoint analysis shows significantly decreasing mortality in all countries except the United Kingdom (+0.5% males between 2007 and 2019, +0.1% females between 2002 and 2019). Incidence rates increased in all countries, with evidence of plateau from 2015 onwards. While MIIs cannot be used as a proxy for survival, statistically significant decreases in MII were observed in all countries. Overall, DALYs remained static.
Over the past 30 years, CM mortality and incidence has increased in most EU15+ countries. There is evidence that in recent years, CM mortality is decreasing. The burden of disease as assessed using DALYs has remained mostly unchanged. Future work should not solely focus on expensive innovative therapies, but also on optimizing primary prevention.
皮肤黑色素瘤（CM）是皮肤癌死亡的主要原因，相关医疗费用高昂。需要及时报告CM的流行病学趋势，以预测未来趋势、评估疾病负担并辅助评估新的诊断、治疗和预防策略。
描述过去三十年中CM死亡率、发病率、死亡率与发病率指数（MII）和伤残调整生命年（DALY）的趋势。
对1990年至2019年期间全球疾病负担（GBD）数据库进行了一项基于人群的横断面研究。纳入了19个卫生支出相似且被归类为拥有高质量死亡率数据的高收入国家，包括英国、美国、澳大利亚和部分欧盟国家。提取了每个国家的年度年龄标准化发病率（ASIR）、年龄标准化死亡率（ASDR）和DALY。通过将ASDR除以ASIR来计算死亡率与发病率指数。使用Joinpoint回归分析描述趋势。
在观察期内，几乎所有国家男性的ASDR都呈上升趋势，希腊上升幅度最大（+87%），女性在各国之间的异质性更大。所有国家男性的CM死亡率均高于女性。最新的Joinpoint分析显示，除英国外，所有国家的死亡率均显著下降（2007年至2019年男性上升0.5%，2002年至2019年女性上升0.1%）。所有国家的发病率均上升，从2015年起有趋于平稳的迹象。虽然MII不能用作生存的替代指标，但所有国家的MII均出现了统计学上的显著下降。总体而言，DALY保持稳定。
在过去30年中，大多数欧盟15国及以上国家的CM死亡率和发病率均有所上升。有证据表明，近年来CM死亡率正在下降。使用DALY评估的疾病负担基本保持不变。未来的工作不应仅关注昂贵的创新疗法，还应注重优化一级预防。
