Cancer surveillance series: Changing patterns of cutaneous malignant melanoma mortality rates among whites in the United States
Cancer surveillance series: Changing patterns of cutaneous malignant melanoma mortality rates among whites in the United States
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DOI：
10.1093/jnci/92.10.811
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发表时间：
2000-05-17
影响因子：
10.3
通讯作者：
Hartge, P
中科院分区：
文献类型：
--
作者：
Jemal, A;Devesa, SS;Hartge, P
背景：在美国，白人黑色素瘤的死亡率仍在上升。在这项研究中，我们通过人口统计学因素和地理因素描述了白人黑色素瘤死亡率的变化模式，并进一步评估了地理模式与紫外线辐射（UV-B）水平之间的关系。研究方法：采用1970年美国人口标准计算黑色素瘤校正的发病率和死亡率，通过将回归线填充到比率的对数来估计死亡率的年百分比变化，通过加权回归来评估黑色素瘤死亡率与UV-B水平随时间的关系。所有统计学检验均为双侧检验。结果：从1950-1954年到1990-1994年，黑色素瘤死亡率在男性和女性中分别增加了191%和84%。死亡率在1930年至1950年出生的女性和1935年至1950年出生的男性中达到峰值。在1950年至1969年的研究期间，黑色素瘤死亡率显示出很强的南北梯度，但最近的梯度减弱了，女性中UV-B增加10%的死亡率的绝对变化从1950-1959年每10万人年增加0.08例死亡下降到1990-1995年增加0.01例死亡，相比之下，男性死亡率的绝对变化几乎没有随时间变化;额外死亡从每10万人年0.11人增加到0.12人。结论：美国黑色素瘤死亡率反映了每个地理区域紫外线辐射水平的复杂相互作用，儿童和成年期每一代男性和女性的防晒行为，人口的地理流动性以及风险意识和早期发现。
Background: Mortality from melanoma among whites is still increasing in the United States. In this study, we describe the changing patterns of melanoma mortality rates among whites by demographic factors and geography and further assess the relationship between the geographic patterns and the UV radiation (UV-B) level. Methods: Age-adjusted incidence and mortality rates were computed by use of the 1970 U.S. population standard, Annual percent changes of mortality were estimated by filling regression lines to the logarithm of rates, The relationships between melanoma mortality rates and UV-B level over time were assessed by weighted regressions. All statistical tests were two-sided. Results: From 1950-1954 through 1990-1994, melanoma mortality rates increased by 191% and 84% among males and females, respectively. Mortality rates peaked in the 1930 through 1950 birth cohorts for females and in the 1935 through 1950 birth cohorts for males. In the 1950 through 1969 study period, melanoma mortality rates showed a strong North-South gradient, but the gradient weakened in recent periods, The absolute change in mortality for a 10% increase in UV-B among females decreased from 0.08 additional deaths per 100 000 person-years in 1950-1959 to 0.01 additional deaths in 1990-1995, In contrast, the absolute change in mortality among males showed little change over time; additional deaths increased from 0.11 to 0.12 per 100 000 person-years. Conclusions: Melanoma mortality in the United States reflects the complex interplay of UV radiation levels in each geographic region, the sun-protection behaviors of each generation of males and females in childhood and adulthood, the geographic mobility of the population, and the risk awareness and early detection.