Lee J A, Scotto J
School of Public Health, University of Washington, Seattle 98195.
Cancer Causes Control. 1993 Sep;4(5):413-8. doi: 10.1007/BF00050859.
The rise in the incidence and mortality from melanoma of the skin is slowing down in younger age groups in the United States. In many White populations, including that of the US, melanoma incidence and mortality rates increase according to proximity of residence to the Equator. Variations with age in this gradient do not seem to have been examined. We examined how the influence of latitude on melanoma rates varied with age. Estimates of age-specific trends by time and by latitude for natural logarithm (Ln) melanoma incidence-rates from the Surveillance, Epidemiology and End Results (SEER) programs, and Ln melanoma mortality rates from the US Vital Statistics were derived from fitted regression equations. Unexpectedly, a decline from old age to youth in the influence of latitude was found for both incidence and mortality from melanoma of the skin in males, and for mortality in females. Further, these changes in the relationship to latitude with age correlated with the changes in time trends with age. The link with exposure suggests that the time trends in melanoma are driven by variations in damage to melanocytes in early life that increases sensitivity to sunlight. This has implications for the general understanding of melanoma etiology and for health education.
在美国，年轻人群体中皮肤黑色素瘤的发病率和死亡率增长正在放缓。在包括美国在内的许多白人种群中，黑色素瘤的发病率和死亡率随着居住地与赤道距离的接近而上升。这种梯度变化随年龄的差异似乎尚未得到研究。我们研究了纬度对黑色素瘤发病率的影响如何随年龄变化。利用拟合回归方程得出了监测、流行病学和最终结果（SEER）项目中按时间和纬度划分的特定年龄组自然对数（Ln）黑色素瘤发病率趋势估计值，以及美国生命统计数据中的Ln黑色素瘤死亡率。出乎意料的是，在男性皮肤黑色素瘤的发病率和死亡率以及女性的死亡率方面，发现从老年到青年纬度影响呈下降趋势。此外，这种与年龄相关的纬度关系变化与随年龄变化的时间趋势变化相关。与暴露的关联表明，黑色素瘤的时间趋势是由早年黑素细胞损伤的变化驱动的，这种变化增加了对阳光的敏感性。这对黑色素瘤病因的总体理解以及健康教育具有启示意义。
