Harrison S L, MacLennan R, Speare R, Wronski I
Anton Breinl Centre, Department of Public Health and Tropical Medicine, James Cook University of North Queensland, Townsville, Australia.
Lancet. 1994 Dec 3;344(8936):1529-32. doi: 10.1016/s0140-6736(94)90348-4.
Queensland, Australia, has the highest rates of melanoma in the world and Queensland children have the greatest numbers of melanocytic naevi, the strongest risk factor for melanoma. Although both melanoma and naevi are broadly related to sun exposure in childhood, the relation to individual exposure early in life is difficult to study retrospectively in adults. We surveyed 506 children aged 1-6 years who had been born in Townsville, North Queensland. Sun exposure was assessed by questionnaire and melanocytic naevi were counted using a standard international protocol. Very high counts (upper quarter) of melanocytic naevi were significantly associated with sun exposure of more than 4 hours per day (adjusted relative risk ratio 3.29; 95% Cl 1.12-9.69), and with a history of sunburn (1.89; 1.11-3.21). Melanocytic naevus counts increased with age, light skin reflectance, and freckling. With exposure to intense ultraviolet light in Townsville, children develop melanocytic naevi early in life and in large numbers. We found that both acute and chronic exposure to sun are associated with their development.
澳大利亚昆士兰州是世界上黑色素瘤发病率最高的地区，昆士兰儿童的黑素细胞痣数量最多，而黑素细胞痣是黑色素瘤最强的风险因素。虽然黑色素瘤和痣都与儿童时期的阳光照射密切相关，但早年个体暴露与阳光照射的关系很难在成年人中进行回顾性研究。我们对506名1至6岁在北昆士兰汤斯维尔出生的儿童进行了调查。通过问卷调查评估阳光照射情况，并使用标准国际方案对黑素细胞痣进行计数。黑素细胞痣数量非常多（上四分位数）与每天超过4小时的阳光照射显著相关（调整后的相对风险比为3.29；95%置信区间为1.12 - 9.69），也与晒伤史相关（1.89；1.11 - 3.21）。黑素细胞痣的数量随着年龄、浅肤色反射率和雀斑的出现而增加。在汤斯维尔，由于暴露于强烈的紫外线下，儿童在生命早期就大量出现黑素细胞痣。我们发现，急性和慢性阳光照射都与黑素细胞痣的形成有关。
