Levi F, Franceschi S, Te V C, Randimbison L, La Vecchia C
Institut universitaire de médecine sociale et préventive, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Br J Cancer. 1995 Oct;72(4):1047-53. doi: 10.1038/bjc.1995.460.
Trends in incidence and mortality for basal cell carcinomas (BCC), squamous cell carcinomas (SCC) and cutaneous malignant melanoma (CMM) for the period 1976-92 were analysed using data from the Cancer Registry of the Swiss Canton of Vaud. Among the 12,473 cases registered, 63% were basal cell carcinomas, 25% squamous cell cancers, 9% cutaneous malignant melanomas and 3% other miscellaneous histological types. Age-standardised incidence rates increased substantially for all histological types considered, from 44% increase for BCC in males to a more than 3-fold increase for SCC in females, with only signs of a levelling off in 1991-92, following a peak of incidence rates in 1986-90. From 1976-80 to 1991-92 CMM incidence increased by approximately 80% in both sexes. In 1991-92, age-standardised (world) incidence rates per 100,000 were 69.3 for basal cell, 29.1 for squamous cell cancers and 11.5 for melanomas in males, and, respectively, 62.2, 18.0 and 12.3 in females. With respect to mortality, in males rates increased for both non-melanocytic cancer (> 40%) and CMM (> 53%) whereas in females CMM, BCC and SCC rates remained approximately stable over the calendar periods examined. In 1991-92, age-standardised mortality rates per 100,000 were 2.6 for melanoma and 0.7 for other skin cancers in males, and, respectively, 1.6 and 0.2 in females. Upward trends in incidence were also present, and relatively homogeneous across, various age groups examined. However, SCC and CMM levelled off over the last period, and some decline was apparent in males below age 45. Separate analysis by anatomical site showed substantial increases in the head and neck for SCC and BCC, and in the trunk for CMM. In 1991-92, middle-aged women had almost equalled male incidence rates of BCC and SCC. A female excess of CMM incidence seemed to have disappeared since 1981-86. The increase in skin cancer incidence thus continued in this population up to the late 1980s, with a plateau only after 1990.
利用瑞士沃州癌症登记处的数据，分析了1976 - 1992年期间基底细胞癌（BCC）、鳞状细胞癌（SCC）和皮肤恶性黑色素瘤（CMM）的发病率和死亡率趋势。在登记的12473例病例中，63%为基底细胞癌，25%为鳞状细胞癌，9%为皮肤恶性黑色素瘤，3%为其他杂类组织学类型。所有考虑的组织学类型的年龄标准化发病率均大幅上升，男性基底细胞癌发病率上升44%，女性鳞状细胞癌发病率上升超过3倍，在1986 - 1990年发病率达到峰值后，1991 - 1992年才略有平稳迹象。从1976 - 1980年到1991 - 1992年，两性的皮肤恶性黑色素瘤发病率均增加了约80%。1991 - 1992年，男性每10万人的年龄标准化（世界）发病率分别为：基底细胞癌69.3、鳞状细胞癌29.1、黑色素瘤11.5；女性分别为62.2、18.0和12.3。关于死亡率，男性非黑色素瘤癌症（>40%）和皮肤恶性黑色素瘤（>53%）的死亡率均上升，而在研究的日历期间，女性的皮肤恶性黑色素瘤、基底细胞癌和鳞状细胞癌的死亡率大致保持稳定。1991 - 1992年，男性每10万人的年龄标准化死亡率分别为：黑色素瘤2.6，其他皮肤癌0.7；女性分别为1.6和0.2。在所研究的各个年龄组中，发病率也呈上升趋势，且相对均匀。然而，鳞状细胞癌和皮肤恶性黑色素瘤在最后阶段趋于平稳，45岁以下男性的发病率有明显下降。按解剖部位进行的单独分析显示，鳞状细胞癌和基底细胞癌在头颈部大幅增加，皮肤恶性黑色素瘤在躯干部位大幅增加。1991 - 1992年，中年女性的基底细胞癌和鳞状细胞癌发病率几乎与男性持平。自1981 - 1986年以来，女性皮肤恶性黑色素瘤发病率过高的情况似乎已经消失。因此，该人群的皮肤癌发病率一直持续上升到20世纪80年代末，1990年后才趋于平稳。
