评估黑色素瘤的性别特异性发病率。
Evaluation of Sex-Specific Incidence of Melanoma.
机构信息
Cancer Control Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
出版信息
JAMA Dermatol. 2020 May 1;156(5):553-560. doi: 10.1001/jamadermatol.2020.0470.
IMPORTANCE
Men and women develop melanoma at different rates on different body sites, with variation across countries, but explanations for these disparities remain elusive.
OBJECTIVE
To test whether observed differences in melanoma incidence between men and women vary by population, age, or anatomic site.
DESIGN
Cross-sectional analysis of sex- and site-specific temporal trends in melanoma incidence over 3 decades was conducted for men and women diagnosed with invasive melanoma in the US (limited to white race), Canada, Australia, New Zealand, the UK, Sweden, Norway, and Denmark. Using cancer registry data, male to female incidence rate ratios (IRRs) were calculated overall and by anatomic site, and Joinpoint regression models were used to estimate the annual percentage rate changes in sex- and site-specific incidence in each population. Incidence rates were standardized to the US 2000 population. Data on the incidence between January 1, 1982, and December 31, 2015, were obtained; analysis was conducted from March 1 to October 15, 2019.
MAIN OUTCOMES AND MEASURES
Male to female IRRs and annual percentage change in rates.
RESULTS
Total melanoma incidence was higher in men than women in US individuals (limited to white race), Canada, Australia, and New Zealand, but not in Denmark, the UK, Norway, and Sweden. In all populations, men had higher rates of melanoma of the head and neck and trunk than women (male to female IRR >1), but lower melanoma rates on the lower limbs (ie, male to female IRR approximately 0.5). The male to female IRR increased log linearly with age, with excess melanomas in women younger than 45 years in all populations (eg, IRR for 20-24 y age group, 0.3 in Denmark and 0.7 in Australia), and excess melanomas in men older than 69 years (eg, IRR for 70-74 y age group, 1.1 in Denmark and 2.1 in the US white population). The age at which the melanoma incidence in men exceeded the melanoma incidence in women differed by population, being achieved the earliest in Australia (45-49 years) and latest in Denmark (65-69 years).
CONCLUSIONS AND RELEVANCE
In predominantly fair-skinned populations, melanoma incidence appears to differ systematically and consistently between men and women by age and anatomic site.
重要性
男性和女性在不同的身体部位以不同的速度患上黑色素瘤，而且这种差异在各国之间存在，但对于这些差异的解释仍然难以捉摸。
目的
检测黑色素瘤发病率在男性和女性之间的观察到的差异是否因人群、年龄或解剖部位而异。
设计
对美国（仅限于白种人）、加拿大、澳大利亚、新西兰、英国、瑞典、挪威和丹麦的男性和女性诊断为侵袭性黑色素瘤的患者进行了 30 年来性别和部位特异性黑色素瘤发病率的横断面分析。使用癌症登记数据，计算了总体和按解剖部位的男性与女性发病率比（IRR），并使用 Joinpoint 回归模型估计了每个人群中性别和部位特异性发病率的年百分比变化率。发病率按美国 2000 年人口进行标准化。获得了 1982 年 1 月 1 日至 2015 年 12 月 31 日之间的发病率数据；分析于 2019 年 3 月 1 日至 10 月 15 日进行。
主要结果和措施
男性与女性的 IRR 和发病率的年百分比变化率。
结果
在美国（仅限于白种人）、加拿大、澳大利亚和新西兰的个体中，黑色素瘤总发病率男性高于女性，但在丹麦、英国、挪威和瑞典则不然。在所有人群中，男性头颈部和躯干的黑色素瘤发病率高于女性（男性与女性 IRR>1），但下肢黑色素瘤发病率较低（即，男性与女性 IRR 约为 0.5）。男性与女性 IRR 随年龄对数线性增加，所有人群中 45 岁以下的女性黑色素瘤发病率过高（例如，20-24 岁年龄组的 IRR，丹麦为 0.3，澳大利亚为 0.7），而 69 岁以上的男性黑色素瘤发病率过高（例如，70-74 岁年龄组的 IRR，丹麦为 1.1，美国白人人口为 2.1）。男性黑色素瘤发病率超过女性黑色素瘤发病率的年龄因人群而异，在澳大利亚最早（45-49 岁），在丹麦最晚（65-69 岁）。
结论和相关性
在主要为浅色皮肤的人群中，黑色素瘤发病率似乎在男性和女性之间按年龄和解剖部位系统且一致地存在差异。
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