Goldstein A M, Tucker M A
Genetic Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892.
Curr Opin Oncol. 1993 Mar;5(2):358-63. doi: 10.1097/00001622-199303000-00015.
Evidence for an increase in the incidence of melanoma and nonmelanoma skin cancers continues to accumulate. Survival after early melanoma is greater than 90%. Survival decreases as tumor thickness increases in a relationship that appears to be more smooth than stepwise. Further evidence that early intermittent sun exposure is a major determinant of risk for melanoma was derived from a case control study in a low-risk population and in a study on migrants to Australia. There is also additional evidence that clinically atypical nevi (dysplastic nevi) are strong predictors of melanoma risk. For public health efforts to be effective in reducing the mortality and morbidity from melanoma and nonmelanoma skin cancers, it is essential to understand the responses of the public and the professional to skin cancer detection efforts and educational programs. Results from several such programs are reviewed. An understanding of the genetics of melanoma continues to grow yet remains complex.
黑色素瘤和非黑色素瘤皮肤癌发病率上升的证据持续积累。早期黑色素瘤患者的生存率超过90%。随着肿瘤厚度增加，生存率下降，这种关系似乎比阶梯式更平滑。早期间歇性日晒是黑色素瘤风险的主要决定因素这一进一步证据，来自一项针对低风险人群的病例对照研究以及一项针对澳大利亚移民的研究。还有额外证据表明，临床上不典型痣（发育异常痣）是黑色素瘤风险的有力预测指标。为使公共卫生措施有效降低黑色素瘤和非黑色素瘤皮肤癌的死亡率和发病率，了解公众和专业人员对皮肤癌检测措施及教育项目的反应至关重要。本文综述了几个此类项目的结果。对黑色素瘤遗传学的认识不断深入，但仍很复杂。
