Invasive and in situ squamous cell carcinoma of the skin: a nationwide study in Iceland
Invasive and in situ squamous cell carcinoma of the skin: a nationwide study in Iceland
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DOI：
10.1111/bjd.19879
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发表时间：
2021-05-09
影响因子：
10.3
通讯作者：
Tryggvadottir, L.
中科院分区：
文献类型：
--
作者：
Adalsteinsson, J. A.;Olafsdottir, E.;Tryggvadottir, L.
背景 全球皮肤鳞状细胞癌 (cSCC) 的发病率正在增加。 目的 评估冰岛原位和侵袭性 cSCC 的肿瘤负担，因为该国人口暴露于有限的紫外线辐射。 方法 这项全人群研究使用了冰岛癌症登记处，其中包含 1981 年至 2017 年所有原位和侵袭性 cSCC 病例的记录。 cSCC 的发病率根据年龄、解剖位置、居住地和年龄进行评估。使用连接点分析评估多样性和趋势。计算每 10 万人年的年龄标准化率 (WSR) 和特定年龄发病率，以及累积风险和终生风险。 结果 1981 年至 2017 年间，原位 cSCC WSR 从男性的 1 个中心点 2 增加到 19 个中心点 1，女性的原位 cSCC WSR 从 2 个中心 0 增加到 22 个中心点 3。男性侵袭性 cSCC WSR 从 4 中心点 6 上升至 14 点，女性从 0 中心点 3 上升至 13 中心点 2。原位 cSCC 病变的平均数量为：每位女性 1 个中心点 71 个，每个男性 1 个中心点 39 个。在几乎所有解剖部位，女性发生的原位 cSCC 多于侵袭性 cSCC，而男性发生的侵袭性 cSCC 较多，主要发生在头部和颈部。与农村地区相比，雷克雅未克的原位鳞状细胞癌发生率更高。此外，女性更常见出现多个原位病变。对于唇部鳞状细胞癌，两性中侵袭性病变的发生率均高于原位病变。 Joinpoint分析显示，女性原位cSCC的发病率增长最快。结论cSCC已成为冰岛日益重要的公共卫生问题。使用日光浴床和出国旅行可能会导致皮肤癌的发生。需要采取公共卫生措施来阻止导致鳞状细胞癌迅速增加的行为。
Background The worldwide incidence of cutaneous squamous cell carcinoma (cSCC) is increasing.Objectives To evaluate the tumour burden of in situ and invasive cSCC in Iceland, where the population is exposed to limited ultraviolet radiation.Methods This whole-population study used the Icelandic Cancer Registry, which contains records of all in situ and invasive cSCC cases from 1981 to 2017. Incidence of cSCC was evaluated according to age, anatomical location, residence and multiplicity, and trends were assessed using joinpoint analysis. Age-standardized rates (WSR) and age-specific incidence rates per 100 000 person-years were calculated, along with cumulative and lifetime risks.Results Between 1981 and 2017, in situ cSCC WSR increased from 1 center dot 2 to 19 center dot 1 for men and from 2 center dot 0 to 22 center dot 3 for women. Invasive cSCC WSR rose from 4 center dot 6 to 14 for men and from 0 center dot 3 to 13 center dot 2 for women. The average number of in situ cSCC lesions was 1 center dot 71 per woman and 1 center dot 39 per man. Women developed more in situ cSCCs than invasive cSCCs in almost all anatomical locations, whereas men developed more invasive cSCCs, mostly on the head and neck. The rates of in situ cSCC were higher in Reykjavik compared with rural areas. Furthermore, women more commonly developed multiple in situ lesions. For lip cSCCs, invasive lesions occurred more frequently than in situ lesions among both sexes. Joinpoint analysis showed that in situ cSCC in women exhibited the most rapid incidence increase.Conclusions cSCC has become an increasingly significant public health problem in Iceland. Tanning bed use and travelling abroad may contribute to skin cancer development. Public health efforts are needed to stem the behaviours leading to this rapid rise in cSCC.