Changing trends in the epidemiology of malignant melanoma: gender differences and their implications for public health.
Changing trends in the epidemiology of malignant melanoma: gender differences and their implications for public health.
复制标题
恶性黑色素瘤流行病学的变化趋势：性别差异及其对公共卫生的影响。
DOI：
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发表时间：
1995
影响因子：
7.7
通讯作者：
Hugh Markowe
中科院分区：
文献类型：
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作者：
Allison Streetly;Hugh Markowe
背景
皮肤癌已被确定为英国健康战略的一个关键领域。按年龄、性别和社会阶层审查黑色素瘤流行病学趋势有助于确保预防工作有适当的针对性，并随后监测运动的效果。
方法
使用按年龄分列的癌症登记数据进行的描述性流行病学研究（英格兰和威尔士，1971-1989年），以及按年龄分列的死亡率统计数据（英格兰和威尔士，1951-1970年;英格兰，1969-1992年）（英格兰和威尔士1970-1972年男子和妇女，英格兰和威尔士1979-1980年、1982-1983年男子，大不列颠1979-1980年、1982-1983年妇女）。分析采用了按性别分列的年龄标准化和年龄别登记率、按性别分列的年龄标准化和年龄别死亡率以及按性别和社会阶层分列的标准化死亡率。队列效应是根据1950-1989年期间年龄和队列特异性死亡率的模型拟合提出的。
结果
1971年至1989年期间，男女恶性黑色素瘤新病例的登记率急剧上升，男性上升190%，女性上升137%。在1970/1972年至1990/1992年期间，年龄标准化死亡率男性增加了92%，女性增加了43%。在15-34岁年龄组，自1970年代后期以来，妇女死亡率有所下降，而男子死亡率保持不变。到1980年代初，非体力劳动职业组男女死亡率都高得多的现象在妇女中有所减少，但在男子中仍然如此。在非体力劳动群体中，男子的死亡率高于妇女，而体力劳动群体的死亡率则相反。
结论
恶性黑色素瘤的死亡率趋势在两性之间存在差异。男性是预防工作的重要目标群体，尽管他们的黑色素瘤发病率较低。他们的死亡率较高，而且还在不断上升，对适当的初级和二级预防措施了解较少，发病较晚，对传统的健康教育方法反应较差。这些发现对初级和二级预防方案的规划具有影响。
BACKGROUND
Skin cancer has been identified as a key area in the English health strategy. Review of trends in the epidemiology of melanoma by age, sex and social class can contribute to ensuring that preventive efforts are targeted appropriately and subsequently to monitoring the effects of campaigns.
METHODS
Descriptive epidemiological study using data for both sexes from cancer registrations by age (England & Wales 1971-1989), and from mortality statistics by age (England & Wales 1951-1970, England 1969-1992) and by social class (England & Wales 1970-1972 for men and women, England & Wales 1979-1980, 1982-1983 for men and Great Britain 1979-1980, 1982-1983 for women). Analysis used age-standardized and age-specific registration rates by sex, age-standardized and age-specific mortality rates by sex and standardized mortality ratios by sex and by social class. Cohort effects are presented based on model fitting of age- and cohort-specific mortality rates for the period 1950-1989.
RESULTS
Registration rates of new cases of malignant melanoma increased sharply in both sexes between 1971 and 1989 by 190% in men and 137% in women. Between 1970/1972 and 1990/1992 age-standardized mortality rates increased by 92% in men and 43% in women. In the 15-34 age group mortality rates have declined in women since the late 1970s whilst remaining level in men. The pattern of significantly higher mortality for both men and women in non-manual occupational groups had by the early 1980s diminished in women although it remained in men. In non-manual groups the mortality rate was higher in men than in women whilst for manual groups the opposite was true.
CONCLUSION
A difference in trends in mortality from malignant melanoma between the sexes was demonstrated. Men are an important target group for preventive efforts despite their lower incidence of melanoma. They have a higher mortality rate which is increasing, less knowledge about appropriate primary and secondary preventive measures, present later with disease and respond less to traditional health education approaches. The findings have implications for the planning of primary and secondary prevention programmes.