Melia J, Ellman R, Chamberlain J
DH Cancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey.
J Public Health Med. 1994 Jun;16(2):225-32. doi: 10.1093/oxfordjournals.pubmed.a042961.
The White Paper The health of the nation challenges us to halt the rising incidence and mortality from skin cancer. Means of achieving this include various approaches to educating the public and modifying sun exposure and promotion of early detection of cancers. Some initiatives can be organized locally but others require national coordination. Evaluation of the impact on health and the cost of preventive programmes is important because the effectiveness of health education packages and campaigns that aim to reduce the incidence or death from skin cancer has yet to be proved. As the majority of skin cancers do not metastasize, it is on melanoma that efforts to improve registration should be focused. Cancer registries have particular difficulty in monitoring the incidence of skin cancer where treatment is simply excision. Improved ascertainment and a shift towards early diagnosis will cause artefactual increases in incidence. Investigation of the trends will therefore require careful interpretation.
白皮书《国家健康》向我们提出挑战，要我们遏制皮肤癌发病率和死亡率不断上升的趋势。实现这一目标的方法包括多种教育公众、改变日晒习惯以及促进癌症早期检测的途径。一些举措可以在地方层面组织开展，但其他举措则需要国家层面的协调。评估预防计划对健康的影响及其成本很重要，因为旨在降低皮肤癌发病率或死亡率的健康教育套餐和活动的有效性尚未得到证实。由于大多数皮肤癌不会发生转移，因此应将提高登记工作的重点放在黑色素瘤上。在治疗仅为切除的情况下，癌症登记机构在监测皮肤癌发病率方面尤其困难。更好的确证以及向早期诊断的转变将导致发病率出现人为上升。因此，对这些趋势的调查需要仔细解读。
