The incidence and mortality of cutaneous melanoma in Southern Germany - Trends by Anatomic Site and Pathologic Characteristics, 1976 to 2003
The incidence and mortality of cutaneous melanoma in Southern Germany - Trends by Anatomic Site and Pathologic Characteristics, 1976 to 2003
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DOI：
10.1002/cncr.22126
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发表时间：
2006-09-15
期刊：
影响因子：
6.2
通讯作者：
Garbe, Claus
中科院分区：
文献类型：
--
作者：
Lasithiotakis, Konstantinos G.;Leiter, Ulrike;Garbe, Claus
背景资料。皮肤黑色素瘤(CM)的发病率和死亡率在过去的两代人中急剧上升，特别是在高加索人群中。在中欧人群中，CM与临床和病理特征有关的详细的、长期的趋势迄今尚未公布。方法：目前的研究是基于1976年至2003年由中央恶性黑色素瘤登记处记录的德国南部1980名侵袭性CM患者。结果：在研究期间，男性和女性的CM发病率大约增加了两倍，分别达到每年10.3/10万和13.3/10万(P<；.001)。增长最大的是位于上肢的黑色素瘤(年变化，男性为5.9%，女性为5.0%；P<；.001)和浅表播散性黑色素瘤(年变化，男性为7.8%，女性为5.9%；P<；.001)。在研究期间，细小肿瘤(布雷斯洛厚度和1毫米)的出现频率显著增加(年变化，男性9.8%，女性6.1%；P<；.001)，主要发生在较年轻的患者中。厚瘤和结节性黑色素瘤在老年患者(年龄70岁)中更为常见，尤其是男性。年龄标化死亡率从1.5/10万男性下降到0.8/10万男性，从2.6/10万女性下降到0.8/10万女性人口有明显的下降趋势(P<；.001)。结论：目前的结果表明，发病率和死亡率之间的差异趋势可能是由于公众对可疑色素病变的认识的提高和这些肿瘤的早期发现所致。有必要继续实施目前的预防战略，并将其扩大到人口中的老年群体。
BACKGROUND. Cutaneous melanoma (CM) incidence and mortality have risen dramatically during the past 2 generations, particularly among Caucasian populations. Detailed, long-term trends of CM in relation to clinical and pathologic characteristics in a Central European population have not been published to date.METHODS. The current study was based on 1980 patients with invasive CM diagnosed in Southern Germany during the years from 1976 to 2003 documented by the Central Malignant Melanoma Registry. The German standard population was used to calculate age-standardized rates, and the annual percent change was estimated by using age, anatomic site, histologic type, and tumor thickness.RESULTS. During the study period, the incidence of CM approximately was tripled for males and females, reaching 10.3 and 13.3 per 100,000 per year, respectively (P < .001). The largest increases occurred for melanoma localized on the upper limbs (annual change, 5.9% for males and 5.0% for females; P < .001) and superficially spreading melanoma (annual change, 7.8% for males and 5.9% for females; P < .001). Thin tumors (Breslow thickness < 1 mm) were presented significantly more often during the study period (annual change, 9.8% for males and 6.1% for females; P < .001), predominantly in younger patients. Thick tumors and nodular melanomas were more frequent among older patients (age > 70 years), particularly among males. The age-standardized mortality decreased from 1.5 to 0.8 per 100,000 males and from 2.6 to 0.8 per 100,000 females with a significant downward trend for the female population (P < .001).CONCLUSIONS. The current results indicated which diverging trends between incidence and mortality may be explained by improved public awareness regarding suspicious pigmented lesions and the earlier detection of these tumors. Continuation of the current preventive strategy and its expansion to include older age groups in the population are warranted.