Increasing burden of melanoma in the United States.
Increasing burden of melanoma in the United States.
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DOI：
10.1038/jid.2008.423
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发表时间：
2009-07
期刊：
影响因子：
--
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中科院分区：
文献类型：
--
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世界范围内黑色素瘤发病率的增加是否代表真正的流行病仍有争议。在死亡率趋势相对稳定的情况下，发病率的急剧增加也归因于扩大皮肤筛查和检测具有低转移潜力的生物学惰性肿瘤。为了更好地了解黑色素瘤发病率趋势如何因诊断时的严重程度和筛查相关因素而变化，我们通过组织学类型、肿瘤厚度和地区社会经济地位（SES）评估了美国近期的发病率和死亡率趋势。我们从监测流行病学和最终结果（SEER）项目（1992-2004）近2.91亿人-年的观察中获得了关于非西班牙裔白人侵袭性黑色素瘤诊断的基于人群的数据。计算SEER和一个子集（加州）的经统计学校正的发病率和死亡率，其中小面积SES测量可用。总体而言，黑色素瘤发病率每年增加3.1%（p<0.001）。所有组织学亚型和厚度的肿瘤（包括> 4 mm的肿瘤）均出现统计学显著性升高。在所有SES组中，黑色素瘤的发病率在10年内翻了一番，而黑色素瘤的死亡率没有显著增加。我们的结论是，较薄的黑色素瘤的筛查相关诊断不能解释较厚的黑色素瘤在低SES人群中的发病率增加，而筛查的机会较少。
It is controversial whether worldwide increases in melanoma incidence represent a true epidemic. Dramatic increases in incidence in the setting of relatively stable mortality trends have also been attributed to expanded skin screening and detection of biologically indolent tumors with low metastatic potential. To better understand how melanoma incidence trends varied by severity at diagnosis and factors relevant to screening access, we assessed recent United States incidence and mortality trends by histologic type, tumor thickness and area-level socioeconomic status (SES). We obtained population-based data regarding diagnoses of invasive melanoma among non-hispanic whites from nearly 291 million person-years of observation by the Surveillance Epidemiology and End Results (SEER) program (1992–2004). Age-adjusted incidence and mortality rates were calculated for SEER and a subset (California) for which small-area SES measure was available. Overall, melanoma incidence increased at 3.1% (p<0.001) per year. Statistically significant rises occurred for tumors of all histologic subtypes and thicknesses, including those >4mm. Melanoma incidence rates doubled in all SES groups over a 10-year period while melanoma mortality rates did not increase significantly. We conclude that screening-associated diagnosis of thinner melanomas cannot explain the increasing rates of thicker melanomas among low SES populations with poorer access to screening.
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影响因子：
10.3
作者：
Jemal, A;Devesa, SS;Tucker, MA
通讯作者：
Tucker, MA
DOI：
10.1016/s0190-9622(99)70562-1
发表时间：
1999-01-01
影响因子：
13.8
作者：
Hall, HI;Miller, DR;Bewerse, B
通讯作者：
Bewerse, B
影响因子：
6.2
作者：
Lasithiotakis, Konstantinos G.;Leiter, Ulrike;Garbe, Claus
通讯作者：
Garbe, Claus
影响因子：
45.3
作者：
Korn, Edward L.;Liu, Ping-Yu;Kirkwood, John M.
通讯作者：
Kirkwood, John M.
影响因子：
8.4
作者：
de Vries, E;Schouten, LJ;Coebergh, JWW
通讯作者：
Coebergh, JWW