International trends in the incidence of malignant melanoma 1953-2008uare recent generations at higher or lower risk?
International trends in the incidence of malignant melanoma 1953-2008uare recent generations at higher or lower risk?
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DOI：
10.1002/ijc.27616
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发表时间：
2013-01-15
影响因子：
6.4
通讯作者：
Bray, Freddie
中科院分区：
文献类型：
--
作者：
Erdmann, Friederike;Lortet-Tieulent, Joannie;Bray, Freddie
在过去的50年里，皮肤恶性黑色素瘤的发病率在以白皙皮肤为主的人群中稳步上升。据报道，最近在几个北欧和西欧国家、澳大利亚、新西兰和北美，这一增长已趋于平稳。我们按国家和性别研究了黑色素瘤发病率的全球模式和时间趋势，重点关注年龄和群体特异性变化。我们分析了来自39个基于人群的癌症登记处的发病率数据，检查了所有年龄段和年龄截短的黑色素瘤标准化发病率，估计了年龄-时期-队列模型的年百分比变化和发病率比。在大多数欧洲国家（主要是南欧和东欧），黑色素瘤的发病率持续上升，而在澳大利亚、新西兰、美国、加拿大、以色列和挪威，近年来发病率已经相当稳定。稳定或下降趋势的迹象主要见于最年轻年龄组（2544岁）。在20世纪40年代末之前出生的几代人中，肥胖率一直在稳步上升，随后在澳大利亚、新西兰、美国、加拿大和挪威，较晚出生的几代人的肥胖率趋于稳定或下降。除了出生队列效应外，还有一种观点认为，在某些人群中，与时期相关的黑色素瘤趋势也有影响。虽然我们的研究结果支持一级和二级预防可以阻止和扭转观察到的黑色素瘤日益增加的负担，但它们也表明这些预防措施需要在许多国家得到进一步的认可。
The incidence of cutaneous malignant melanoma has steadily increased over the past 50 years in predominately fair-skinned populations. This increase is reported to have leveled off recently in several Northern and Western European countries, Australia, New Zealand and in North America. We studied the global patterns and time trends in incidence of melanoma by country and sex, with a focus on and age- and cohort-specific variations. We analyzed the incidence data from 39 population-based cancer registries, examining all-ages and age-truncated standardized incidence rates of melanoma, estimating the annual percentage change and incidence rate ratios from age-period-cohort models. Incidence rates of melanoma continue to rise in most European countries (primarily Southern and Eastern Europe), whereas in Australia, New Zealand, the U.S., Canada, Israel and Norway, rates have become rather stable in recent years. Indications of a stabilization or decreasing trend were observed mainly in the youngest age group (2544 years). Rates have been rising steadily in generations born up to the end of the 1940s, followed by a stabilization or decline in rates for more recently born cohorts in Australia, New Zealand, the U.S., Canada and Norway. In addition to the birth cohort effect, there was a suggestion of a period-related influence on melanoma trends in certain populations. Although our findings provide support that primary and secondary prevention can halt and reverse the observed increasing burden of melanoma, they also indicate that those prevention measures require further endorsement in many countries.