Non-melanoma skin cancer and solar keratoses .1. Methods and descriptive results of the South Wales skin cancer study
Non-melanoma skin cancer and solar keratoses .1. Methods and descriptive results of the South Wales skin cancer study
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DOI：
10.1038/bjc.1996.534
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发表时间：
1996-10-01
影响因子：
8.8
通讯作者：
NolanFarrell, M
中科院分区：
文献类型：
--
作者：
Harvey, I;Frankel, S;NolanFarrell, M
本研究旨在描述随机人群样本中日光性角化病和皮肤癌的患病率和发病率以及日光性角化病的自然史。这是一项有随访的横断面研究。在南威尔士进行，涉及1034名年龄在60岁及以上的受试者，来自家庭健康服务管理局登记册。主要结果指标是检测日光暴露皮肤上日光角化病和皮肤癌的存在，以及日光角化病的摄影验证和可能的癌症活检确认。我们发现日光性角化病的患病率为23%（95%置信区间19.5-26.5），皮肤癌（所有类型）的患病率为2%（95%置信区间1.0-3.5）。日光性角化病的发病率为149个病变/1000人-年，非黑色素瘤皮肤癌的发病率为9个/1000人-年。在随访期间，共有21%（95% CL 16-26）的日光性角化病自发消退。无一例发生恶变。我们认为，由于个人不寻求医疗建议，以及非黑色素瘤皮肤癌登记不足，因此基于人群的研究非常重要。在这一随机抽样中，恶性和癌前皮肤病变的高患病率和发病率引起了重大的公共卫生问题。日光性角化病的高自然消退率和低恶变率挑战了关于这些病变需要常规治疗的传统观点。
This study aimed to describe the prevalence and incidence of solar keratoses and skin cancers and the natural history of solar keratoses in a random population sample. It was a cross-sectional study, with follow-up. conducted in South Wales, and involved 1034 subjects aged 60 years and over drawn from the Family Health Services Authority register. The main outcome measures were detection of the presence of solar keratoses and skin cancers on sun-exposed skin and photographic validation of solar keratoses and biopsy confirmation of cancers wherever possible. We found that solar keratosis prevalence was 23% (95% confidence interval 19.5-26.5) and that of skin cancer (all types) 2% (95% confidence interval 1.0-3.5). The incidence rate of solar keratoses was 149 lesions per 1000 person-years and of non-melanoma skin cancer 9 per 1000 person-years. In all 21% (95% CL 16-26) of solar keratoses regressed spontaneously during follow-up. None underwent malignant change. We believe that the failure of individuals to seek medical advice and the variable under-registration of non-melanoma skin cancer makes population-based study important. The high prevalence and incidence of malignant and pre-malignant skin lesions in this random sample raise major public health concerns. The high rate of spontaneous regression of solar keratoses and the low rate of malignant change challenges conventional views about the need for routine treatment of these lesions.