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老年人黑色素瘤发病率上升:明尼苏达州奥尔姆斯特德县的一项流行病学研究

Increasing Incidence of Melanoma in the Elderly: An Epidemiological Study in Olmsted County, Minnesota.

作者信息

Olazagasti Lourido Jeannette M, Ma Janice E, Lohse Christine M, Brewer Jerry D

机构信息

Mayo Graduate School, Mayo Clinic College of Medicine, Rochester, MN.

Mayo Medical School, Mayo Clinic College of Medicine, Rochester, MN.

出版信息

Mayo Clin Proc. 2016 Nov;91(11):1555-1562. doi: 10.1016/j.mayocp.2016.06.028. Epub 2016 Sep 28.

Abstract

OBJECTIVE

To estimate the age- and sex-adjusted incidence of melanoma in adults 61 years or older in Olmsted County, Minnesota, from 1970 through 2009.

PATIENTS AND METHODS

Using Rochester Epidemiology Project resources, 397 patients were identified who were 61 years or older and who received a first lifetime diagnosis of melanoma from January 1, 1970, through December 31, 2009, in Olmsted County. The incidence of melanoma and the overall and disease-specific survival rates were compared by age, sex, year of diagnosis, and stage of disease.

RESULTS

From 1970 through 2009, age- and sex-adjusted incidence increased significantly (P<.001) from 17.0 (95% CI, 8.6-25.4) to 124.6 (95% CI, 108.9-140.3) per 100,000 person-years, with a 4-fold increase in women and a more than 11-fold increase in men. In men, incidence rates increased with age (P<.001) and over time (P<.001). In women, incidence rates increased over time (P<.001) but were constant across all age groups studied (P=.90). The dramatic increase in the incidence of melanoma was observed mainly for stages 0 and I tumors in both men and women (>55-fold increase). Disease-specific survival increased across the decades (P<.001); when year of diagnosis was compared to mortality, hazard ratios were 0.94 (95% CI, 0.90-0.99; P=.010) and 0.93 (95% CI, 0.89-0.98; P=.006) for men and women, respectively.

CONCLUSION

The incidence of melanoma in older men and women increased significantly over the past 4 decades in Olmsted County, with men experiencing higher rates of increase than did women.

摘要

目的

评估1970年至2009年明尼苏达州奥姆斯特德县61岁及以上成年人中经年龄和性别调整后的黑色素瘤发病率。

患者与方法

利用罗切斯特流行病学项目资源,确定了397例61岁及以上患者,他们于1970年1月1日至2009年12月31日在奥姆斯特德县首次被诊断为黑色素瘤。比较了黑色素瘤的发病率以及总体生存率和疾病特异性生存率,比较因素包括年龄、性别、诊断年份和疾病分期。

结果

1970年至2009年,经年龄和性别调整后的发病率显著增加(P<0.001),从每10万人年17.0(95%可信区间,8.6 - 25.4)增至124.6(95%可信区间,108.9 - 140.3),女性增加了4倍,男性增加了11倍多。在男性中,发病率随年龄增长(P<0.001)且随时间推移而增加(P<0.001)。在女性中,发病率随时间增加(P<0.001),但在所有研究年龄组中保持稳定(P = 0.90)。黑色素瘤发病率的显著增加主要见于男性和女性的0期和I期肿瘤(增加超过55倍)。几十年来疾病特异性生存率有所提高(P<0.001);将诊断年份与死亡率进行比较时,男性和女性的风险比分别为0.94(95%可信区间,0.90 - 0.99;P = 0.010)和0.93(95%可信区间,0.89 - 0.98;P = 0.006)。

结论

在过去40年里,奥姆斯特德县老年男性和女性的黑色素瘤发病率显著增加,男性的增长率高于女性。

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