ATYPICAL NEVI IN MELANOMA--A CASE-CONTROL STUDY

尽管人们对作为黑色素瘤危险因素的非典型痣非常感兴趣 和先兆，对这些损害的危险因素知之甚少，或者 它们在黑色素瘤病因学中的作用。之前的病例对照研究有 评估为黑色素瘤危险因素的非典型痣较小和/或临床 基于。同样，只有几项基于临床的小型研究检查过 非典型痣的危险因素。我们的主要目标是1)开展一项 非家族性黑色素瘤的大规模、基于人群的病例对照研究 评估非典型痣、良性痣、日光敏感度和太阳暴露量 作为风险因素，以及2)进行大规模、基于人群的评估 非典型痣的危险因素。在单独的分析中，我们将探索 与黑色素瘤亚组相关的风险因素基于a)存在或 B)肿瘤组织学类型。作为第三级 目的，我们提出了一个验证子研究，将评估受试者 能准确地自我诊断不典型痣。至少有几个案例 通过NH州立癌症登记中心确诊的黑色素瘤将被 在五年的学习期内注册。我们将招收800人 从驾驶执照名单(65岁或65岁以下)中识别的控制者，以及 医疗保险受益人名单(年龄大于65岁)。同意受试者 将完成电话采访，进行皮肤自我检查，以及 参加皮肤科医生进行的皮肤检查。基于 皮肤科检查，所有科目将被归类为“有”或 “没有”非典型雀斑。我们的统计方法将包括两个 评估1)黑色素瘤危险因素的初步病例对照分析 2)非典型痣的危险因素。此外，我们还将进行 单独进行病例对照比较，以探讨特定疾病的危险因素 黑色素瘤亚型。我们的方法将阐明黑色素瘤的病因， 并找出非典型痣的危险因素。最后，我们将评估 受试者自我筛查非典型痣的能力 对皮肤科医生结果的自查结果 考试。自我诊断非典型痣的能力很重要。 对黑色素瘤预防的启示。

Despite substantial interest in atypical nevi as melanoma risk factors and precursors, little is known about risk factors for these lesions, or their role in melanoma etiology. Previous case-control studies that have assessed atypical nevi as melanoma risk factors were small and/or clinic based. Similarly, only a few small, clinic-based studies have examined risk factors for atypical nevi. Our primary aims are to 1) conduct a large, population-based, case-control study of nonfamilial melanoma to evaluate atypical nevi, benign nevi, sun sensitivity, and solar exposure as risk factors, and 2) conduct a large, population-based evaluation of risk factors for atypical nevi. In separate analyses, we will explore risk factors associated with melanoma subgroups based on a) presence or absence of atypical nevi, and b) tumor histologic type. As a tertiary aim, we propose a validation substudy that will evaluate whether subjects can accurately self-diagnose atypical nevi. At least 535 cases of melanoma, ascertained through the NH State Cancer Registry, will be enrolled over a five year study period. We will enroll 800 population controls identified from drivers' license lists (age 65 or less), and medicare beneficiary lists (age greater than 65). Consenting subjects will complete a telephone interview, conduct skin self-examination, and participate in a dermatologist-conducted skin examination. Based on the dermatology examination, all subjects will be classified as "with" or "without" atypical nevi. Our statistical approach will include two primary case-control analyses to evaluate 1) risk factors for melanoma, and 2) risk factors for atypical nevi. In addition, we will conduct separate case-control comparisons to explore risk factors for specific melanoma subsets. Our approach will elucidate the etiology of melanoma, and identify risk factors for atypical nevi. Finally, we will evaluate subjects' ability to self-screen for atypical nevi by comparing the results of self-examination to the results of the dermatologist examination. The ability to self-diagnose atypical nevi has important implications for melanoma prevention.