MacKie R M
Department of Dermatology, University of Glasgow, U.K.
Eur J Cancer. 1998 Jul;34 Suppl 3:S3-6. doi: 10.1016/s0959-8049(98)00003-3.
The incidence of cutaneous malignant melanoma steadily increased between 1940 and 1990 in both sexes. However, this increase appears to have peaked in females in Scotland. Excessive exposure to ultraviolet radiation among Caucasians is the main etiologic factor implicated in the incidence of melanoma. Mortality due to melanoma also increased between 1940 and 1990, but the rate of increase is less than that of the incidence of melanoma. This may be due to earlier diagnosis and treatment of melanoma as a result of public education campaigns. Independent risk factors for developing melanoma include the presence of benign melanocytic naevi (moles), the development of lentigines or freckles, three or more dysplastic naevi and a history of three or more severe sunburns that resulted in peeling or blistering. Approximately 2% of melanoma patients have a family history of the disease and research into potential melanoma susceptibility genes is ongoing. Primary prevention campaigns, initiated mainly in Australia, are aimed at encouraging sensible sun exposure. Secondary prevention campaigns are directed at preventing death from melanoma by encouraging early diagnosis and treatment. Additional prospective studies are needed to determine if the incidence of melanoma has peaked and whether the recent trends observed in females will also occur in males.
1940年至1990年间，男女皮肤恶性黑色素瘤的发病率均稳步上升。然而，这种上升在苏格兰女性中似乎已达到峰值。白种人中过度暴露于紫外线辐射是黑色素瘤发病率的主要病因。1940年至1990年间，黑色素瘤导致的死亡率也有所上升，但上升速度低于黑色素瘤的发病率。这可能是由于公众教育活动使黑色素瘤得到了更早的诊断和治疗。发生黑色素瘤的独立危险因素包括存在良性黑素细胞痣（痣）、出现雀斑或晒斑、三个或更多发育异常痣以及有三次或更多次导致脱皮或起泡的严重晒伤史。约2%的黑色素瘤患者有该病的家族病史，目前正在对潜在的黑色素瘤易感基因进行研究。主要在澳大利亚发起的一级预防活动旨在鼓励合理晒太阳。二级预防活动旨在通过鼓励早期诊断和治疗来预防黑色素瘤导致的死亡。需要进行更多前瞻性研究，以确定黑色素瘤的发病率是否已达到峰值，以及在女性中观察到的近期趋势是否也会在男性中出现。
