1960 - 2022年斯堪的纳维亚半岛后葡萄膜黑色素瘤发病率上升：一项三国研究。

Increasing Incidence of Posterior Uveal Melanoma in Scandinavia 1960-2022: A Tri-National Study.

作者信息

Nissen Kristoffer, Kiilgaard Jens Folke, Fili Maria, Seregard Stefan, Navaratnam Jesintha, Krohn Jørgen, Pedersen Bærland Thomas, Eid Robsahm Trude, Eide Nils, Stålhammar Gustav

机构信息

From the Department of Ophthalmology (K.N., J.F.K.), Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.

Ocular Oncology Service (M.F., G.S.), St. Erik Eye Hospital, Stockholm, Sweden; Department of Clinical Neuroscience (M.F., S.S., G.S.), Karolinska Institute, Stockholm, Sweden.

出版信息

Am J Ophthalmol. 2025 Jun;274:131-141. doi: 10.1016/j.ajo.2025.03.002. Epub 2025 Mar 5.

DOI:10.1016/j.ajo.2025.03.002

PMID:40054546

Abstract

PURPOSE

To investigate temporal trends in the incidence of posterior uveal melanoma in Scandinavia (Sweden, Denmark, and Norway) between 1960 and 2022 and explore potential associations with changes in tumor size and patient age at diagnosis.

DESIGN

Retrospective, registry-based cohort study utilizing nationwide data from the 3 Scandinavian countries.

PARTICIPANTS

All patients diagnosed with posterior uveal melanoma (choroid or ciliary body) in Sweden (1960-2022), Denmark (1960-2022), and Norway (1993-2022), totaling 10,154 cases. Iris melanomas were excluded.

METHODS

Crude, age-standardized, and log-transformed age-standardized incidence rates were calculated using direct standardization (1970-1974 population). Linear regression was applied to assess trends in incidence, largest basal diameter (LBD), tumor thickness, and patient age at diagnosis. A multivariate linear regression model tested whether tumor size or patient age accounted for the time-dependent increase in incidence. P values were Bonferroni-adjusted for multiple comparisons.

MAIN OUTCOME MEASURES

Crude, age-standardized, and log-transformed age-standardized incidence rates of posterior uveal melanoma.

RESULTS

Crude, age-standardized, and log-transformed age-standardized incidence rates increased significantly in all 3 countries. Combined Scandinavian age-standardized rates rose from 5.2 to 6.8 per million inhabitants and year in the 1960s to 6.1-8.7 in the 2010s (slope 0.033; 95% CI: 0.022-0.044). Log-transformed rates showed a similar upward trend (slope 0.002; 95% CI: 0.002-0.003). Tumor size (diameter and thickness) decreased, while patient age at diagnosis increased over time. Multivariate analysis confirmed a time-dependent increase in incidence, independent of tumor size or patient age.

CONCLUSIONS

Posterior uveal melanoma incidence in Scandinavia has increased since 1960. The linear trend is independent of changes in tumor size or patient age.

摘要

目的

调查1960年至2022年斯堪的纳维亚半岛（瑞典、丹麦和挪威）后葡萄膜黑色素瘤的发病率随时间的变化趋势，并探讨其与诊断时肿瘤大小和患者年龄变化之间的潜在关联。

设计

基于登记处的回顾性队列研究，利用来自3个斯堪的纳维亚国家的全国性数据。

参与者

瑞典（1960 - 2022年）、丹麦（1960 - 2022年）和挪威（1993 - 2022年）所有被诊断为后葡萄膜黑色素瘤（脉络膜或睫状体）的患者，共计10154例。虹膜黑色素瘤被排除在外。

方法

使用直接标准化法（以1970 - 1974年人口为标准）计算粗发病率、年龄标准化发病率和对数转换后的年龄标准化发病率。应用线性回归评估发病率、最大基底直径（LBD）、肿瘤厚度和诊断时患者年龄的趋势。多变量线性回归模型检验肿瘤大小或患者年龄是否可解释发病率随时间的增加。P值经Bonferroni校正用于多重比较。

主要观察指标

后葡萄膜黑色素瘤的粗发病率、年龄标准化发病率和对数转换后的年龄标准化发病率。

结果

在所有3个国家，粗发病率、年龄标准化发病率和对数转换后的年龄标准化发病率均显著增加。斯堪的纳维亚半岛合并的年龄标准化发病率从20世纪60年代的每百万居民每年5.2例升至6.8例，到2010年代为6.1 - 8.7例（斜率0.033；95%置信区间：0.022 - 0.044）。对数转换后的发病率呈现类似的上升趋势（斜率0.002；95%置信区间：0.002 - 0.003）。随着时间推移，肿瘤大小（直径和厚度）减小，而诊断时患者年龄增加。多变量分析证实发病率随时间增加，与肿瘤大小或患者年龄无关。