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老年人黑色素瘤发病率上升,死亡率下降:明尼苏达州奥姆斯特德县的一项流行病学研究。

Increasing Incidence and Decreasing Mortality of Melanoma in Elderly Adults: An Epidemiologic Study in Olmsted County, Minnesota.

机构信息

Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota.

Department of Dermatology, Division of Dermatopathology, Mayo Clinic, Rochester, Minnesota.

出版信息

Dermatol Surg. 2024 Feb 1;50(2):125-130. doi: 10.1097/DSS.0000000000003972. Epub 2023 Oct 3.

Abstract

BACKGROUND AND OBJECTIVE

Primary cutaneous melanoma incidence is increasing in elderly individuals. This population-based cohort examines incidence and mortality rates among adults aged 61 years and older with cutaneous melanoma.

MATERIALS AND METHODS

Using the Rochester Epidemiology Project, patients aged 61 years of age or older with a first lifetime diagnosis of cutaneous melanoma between January 1, 1970 and December 31, 2020 were identified.

RESULTS

The age- and sex-adjusted incidence rate increased from 16.4 (95% CI, 8.2-24.6) per 100,000 person-years in 1970 to 1979 to 201.5 (95% CI, 185.1-217.8) per 100,000 person-years in 2011 to 2020 (12.3-fold increase). There was a 16.0x increase in males and an 8.5× increase in females. Melanoma incidence has stabilized in males (1.2-fold increase, p = .11) and continues to significantly increase in females (2.7-fold increase, p < .001). Older age at diagnosis was significantly associated with an increased risk of death (HR 1.23 per 5-year increase in age at diagnosis, 95% CI, 1.02-1.47).

CONCLUSION

Melanoma incidence continues to increase since 1970. The incidence has risen in elderly females, but has stabilized in males. Mortality has decreased throughout this period.

摘要

背景与目的

原发性皮肤黑色素瘤的发病率在老年人中逐渐增加。本基于人群的队列研究旨在检查 61 岁及以上患有皮肤黑色素瘤的成年人的发病率和死亡率。

材料与方法

利用罗切斯特流行病学项目,确定了 1970 年 1 月 1 日至 2020 年 12 月 31 日期间首次确诊为皮肤黑色素瘤的年龄在 61 岁及以上的患者。

结果

年龄和性别调整后的发病率从 1970 年至 1979 年的 16.4(95%置信区间,8.2-24.6)每 100,000 人年增加到 2011 年至 2020 年的 201.5(95%置信区间,185.1-217.8)每 100,000 人年(增加了 12.3 倍)。男性发病率增加了 16.0 倍,女性发病率增加了 8.5 倍。男性黑色素瘤发病率已趋于稳定(增加了 1.2 倍,p =.11),而女性黑色素瘤发病率仍在显著增加(增加了 2.7 倍,p <.001)。诊断时年龄越大,死亡风险越高(诊断时年龄每增加 5 岁,死亡风险增加 1.23 倍,95%置信区间,1.02-1.47)。

结论

自 1970 年以来,黑色素瘤的发病率持续上升。在老年女性中发病率上升,但在男性中已趋于稳定。在这一时期,死亡率一直在下降。

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