Trends in the survival of patients diagnosed with malignant melanoma of the skin in the Nordic countries 1964-2003 followed up to the end of 2006
Trends in the survival of patients diagnosed with malignant melanoma of the skin in the Nordic countries 1964-2003 followed up to the end of 2006
复制标题
DOI：
10.3109/02841861003702528
复制
发表时间：
2010-06-01
期刊：
影响因子：
3.1
通讯作者：
Bray, Freddie
中科院分区：
文献类型：
--
作者：
Tryggvadottir, Laufey;Gislum, Mette;Bray, Freddie
先前的北欧研究显示，在1958年至1987年期间诊断的皮肤黑色素瘤患者的年龄调整的5年相对生存率显著且稳定地增加。雄性的存活率比雌性差得多。材料和方法。使用NORDCAN数据库，我们研究了1964-2003年北欧国家皮肤黑色素瘤患者的相对生存率和超额死亡率，随访至2006年底。这些与发病率和死亡率的伴随趋势形成对比。结果黑色素瘤的总体发病率几乎翻了两番，但这五个国家的趋势有相当大的差异。死亡率很低，但在研究期间翻了一番。1999-2003年确诊的患者的存活率稳步上升至80%至90%。瑞典患者的生存率一直较高，而丹麦患者在诊断后的前三个月内的超额死亡率最高，直到1990年，但此后，死亡率达到了与其他北欧国家相似的低水平。北欧妇女的存活率仍然高于男子，但这种差别已经缩小，而在50岁及50岁以上的人中，男子的死亡率越来越高于妇女。在较年轻的个体中，男女的死亡率相似，而且在下降。结论.北欧黑色素瘤诊断后的患者生存率通常很高，并且在过去几十年中一直在稳步上升。五个国家之间的发病率差异比生存率差异更明显。发病率和生存率的强劲上升趋势可能主要是日光浴习惯或其他紫外线暴露的广泛变化的结果，以及最近医学界和公众对皮肤黑色素瘤早期检测的认识不断提高的结果。
A previous Nordic study showed a marked and steady increase in the age-adjusted 5-year relative survival of skin melanoma patients diagnosed during the period 1958 through 1987. Males had considerably poorer survival than females. Material and methods. Using the NORDCAN database, we studied relative survival and excess mortality of patients diagnosed with melanoma of the skin in the Nordic countries 1964-2003 followed up to the end of 2006. These were contrasted with concomitant trends in incidence and mortality. Results. The overall incidence of melanoma almost quadrupled, but there was considerable variation in the trends in the five countries. Mortality was low but doubled during the study period. Survival ratios increased steadily to between 80% and 90% for patients diagnosed in 1999-2003. Swedish patients had consistently higher survival, whereas Danish patients had the highest excess death rates the first three months after diagnosis up until 1990, but thereafter, rates reached a similar low level to that observed in the other Nordic countries. The survival of Nordic women is still higher than that of men, but the difference has diminished, while the mortality rates among men are becoming increasingly higher relative to those for women among individuals 50 years and older. In younger individuals, mortality rates are similar in the two sexes, and declining. Conclusions. Nordic patient survival following melanoma diagnosis is generally high and has been steadily increasing in the last decades. Differences in incidence between the five countries are more pronounced than the differences in survival. The strong upward trends in incidence and survival may mainly be the result of extensive changes in sunbathing habits or other UV exposure and, more recently, of an increasing awareness by the medical community and the public concerning early detection of melanoma of the skin.