EPIDEMIOLOGY OF MALIGNANT-MELANOMA
EPIDEMIOLOGY OF MALIGNANT-MELANOMA
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DOI：
10.1093/oxfordjournals.bmb.a072978
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发表时间：
1995-07-01
影响因子：
6.7
通讯作者：
DORE, JF
中科院分区：
文献类型：
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作者：
BOYLE, P;MAISONNEUVE, P;DORE, JF
虽然皮肤恶性黑色素瘤在许多人群中仍然是一种相对罕见的肿瘤，但世界各地高加索人群的发病率正在增加。皮肤癌的发病率在本世纪急剧增加，特别是在北方：最可靠的统计数据涉及恶性黑色素瘤，在许多国家，其发病率每10年翻一番。事实上，除了妇女肺癌之外，这一增长率已超过任何癌症，尽管来自北欧国家和北欧国家的一些证据表明，年轻群体的增长率可能正在放缓。在英国和德国，恶性黑色素瘤的发病率现在约为每年10/100，000，其终生风险约为1/200。首先，黑色素瘤有一个强烈的倾向，有一个家族的风险组成部分。这可能是由于一些基本的遗传因素，也可能与黑色素瘤风险因素在家族中的倾向有关。这些包括红头发，蓝眼睛，浅色皮肤和非典型痣综合征/发育不良痣综合征，也由遗传因素决定。第二个主要因素是，对于那些对恶性黑色素瘤没有强烈遗传易感性的人来说，可能有一些环境因素能够改变患黑色素瘤的风险，并导致临床肿瘤的发展。黑色素瘤的趋势和目前对风险因素的理解令人担忧的一个方面是，这些趋势可能会因急性暴露于阳光（日光浴）的进一步增加而加剧，并可能导致平流层臭氧层的消耗。因此，黑色素瘤被确定为一种癌症，在缺乏有效干预的情况下，它将在未来几十年内在公共卫生方面变得非常重要。据估计，1985年全世界已确诊92，000例，占总数的1.2
Although cutaneous malignant melanoma is still a relatively rare neoplasm in many populations, incidence rates are increasing in Caucasian populations around the world. The incidence of skin cancer has increased dramatically this century particularly in Northern Europe: the most reliable statistics pertain to malignant melanoma which has doubled in incidence every 10 years in many countries. Indeed the rate of increase has exceeded that of any cancer except for lung cancer in women, although there is some evidence from the Umted States and Nordic countries that the rate of increase may be slowing in younger cohorts. The incidence of malignant melanoma in the United Kingdom and Germany is now approximately 10 per 100,000 per annum giving an approximate lifetime risk of 1 in 200.The search for an understanding of the causes of these increases in malignant melanoma focuses on several areas. First of all, there is a strong tendency for melanoma to have a familial component to risk. This may be due to some basic genetic factor or it could be related to the tendency for melanoma risk factors to run in families. Those include red hair, blue eyes, light skin and atypical mole syndromes/dysplastic naevus syndromes and are also determined by genetic factors. The second major factor is that for individuals with no strong genetic susceptibility to malignant melanoma, there may be some environmental factor which is capable of altering the risk of melanoma and leading to the development of a clinical tumour. A worrying aspect of the trends in melanoma and current understanding of risk factors is that these trends may be exacerbated by further increases in acute exposures to sunshine (sunbathing), and possibly the depletion of the stratospheric ozone layer. Thus, melanoma is identified as one form of cancer which will become very important in public health terms in coming decades in the absence of effective intervention. There are already an estimated 92,000 cases diagnosed world-wide in 1985 which represented 1.2% of the total