Chen Y T, Zheng T, Holford T R, Berwick M, Dubrow R
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034.
Cancer Causes Control. 1994 Jul;5(4):341-50. doi: 10.1007/BF01804985.
This study examined time trends and age-period-cohort patterns in the incidence of cutaneous malignant melanoma (CMM) by gender and anatomic site in Connecticut (United States) between 1950 and 1989, using data from the population-based Connecticut Tumor Registry. A total of 8,249 invasive CMM incident cases were included. Cases were grouped into melanomas of the head and neck, upper limb, lower limb, and trunk. Between 1950 and 1989, rates increased substantially for all sites. The largest relative increases occurred in melanoma of the upper limb for both males and females; the largest absolute increase occurred for melanoma of the trunk in males; and the smallest increase occurred in head and neck melanoma in females. Recent trends for time periods 1970-89 among birth cohorts 1930-69 indicated that the rate of increase of CMM is slowing substantially among males, but not among females. Nevertheless, continued overall increases in CMM incidence are likely in Connecticut in the 1990s in both genders, with a decrease in the male-female ratio. The age-period-cohort patterns were significantly different between the genders and among anatomic sites, suggesting different trends in carcinogenic exposures (mainly ultraviolet radiation from the sun) or etiologic distinctions between males and females and among the sites.
本研究利用基于人群的康涅狄格肿瘤登记处的数据，调查了1950年至1989年间美国康涅狄格州皮肤恶性黑色素瘤（CMM）发病率按性别和解剖部位划分的时间趋势以及年龄-时期-队列模式。共纳入8249例浸润性CMM发病病例。病例分为头颈部、上肢、下肢和躯干黑色素瘤。1950年至1989年间，所有部位的发病率均大幅上升。男性和女性上肢黑色素瘤的相对增幅最大；男性躯干黑色素瘤的绝对增幅最大；女性头颈部黑色素瘤的增幅最小。1970 - 1989年期间出生队列1930 - 1969年的近期趋势表明，男性CMM的发病率增长大幅放缓，但女性并非如此。尽管如此，20世纪90年代康涅狄格州男女CMM发病率可能仍会持续总体上升，男女比例会下降。年龄-时期-队列模式在性别之间和解剖部位之间存在显著差异，这表明致癌暴露（主要是来自太阳的紫外线辐射）存在不同趋势，或者男性与女性以及不同部位之间存在病因差异。
