皮肤黑素瘤(以下称为黑素瘤)的发病率在全世界皮肤白皙的人群中急剧增加。在挪威,黑色素瘤是生长最快的癌症,2000-2016年女性增长47%,男性增长57%。生命早期的间歇性紫外线照射和表型特征,如白皙的肤色,雀斑和痣是既定的危险因素,然而黑素瘤的病因是多因素的。某些处方药可能对黑色素瘤的风险有致癌副作用。一些心血管疾病,抗抑郁药和免疫抑制药物可以影响某些调节光敏性和免疫调节的生物过程。我们的目的是研究这些药物是否与黑色素瘤风险有关。
将使用全国范围的注册数据进行基于人群的匹配病例对照研究。案件将包括所有第一主要案件,2007年至2015年在挪威癌症登记处发现的组织学证实的黑色素瘤病例(14000例)。根据挪威国家登记处的性别和出生年份,每个病例(黑色素瘤诊断日期)将匹配十个无黑色素瘤对照。在2004-2015年期间,通过使用分配给所有挪威公民的唯一个人识别号码,病例对照数据集将链接到挪威处方数据库,以获取有关黑色素瘤诊断之前分配的药物的信息,并向挪威医学出生登记处提供有关分娩人数的数据。条件逻辑回归将用于估计药物使用与黑色素瘤风险之间的关联,考虑到潜在的混杂因素。
该项目由挪威医学研究伦理区域委员会和挪威数据保护局批准。该研究由挪威东南部地区卫生局资助。结果将在同行评审的期刊上发表,并通过科学会议进一步传播,新闻媒体和相关患者利益集团。
The incidence of cutaneous melanoma (hereafter melanoma) has increased dramatically among fair-skinned populations worldwide. In Norway, melanoma is the most rapidly growing type of cancer, with a 47% increase among women and 57% among men in 2000-2016. Intermittent ultraviolet exposure early in life and phenotypic characteristics like a fair complexion, freckles and nevi are established risk factors, yet the aetiology of melanoma is multifactorial. Certain prescription drugs may have carcinogenic side effects on the risk of melanoma. Some cardiovascular, antidepressant and immunosuppressive drugs can influence certain biological processes that modulate photosensitivity and immunoregulation. We aim to study whether these drugs are related to melanoma risk.
A population-based matched
case-control study will be conducted using nation-wide registry data. Cases will consist of all first primary, histologically verified melanoma cases diagnosed between 2007 and 2015 identified in the Cancer Registry of Norway (14 000 cases). Ten melanoma-free controls per
case (on date of
case melanoma diagnosis) will be matched based on sex and year of birth from the National Registry of Norway. For the period 2004-2015, and by using the unique personal identification numbers assigned to all Norwegian citizens, the
case-control data set will be linked to the Norwegian Prescription Database for information on drugs dispensed prior to the melanoma diagnosis, and to the Medical Birth Registry of Norway for data regarding the number of child births. Conditional logistic regression will be used to estimate associations between drug use and melanoma risk, taking potential confounding factors into account.
The project is approved by the Regional Committee for Medical Research Ethics in Norway and by the Norwegian Data Protection Authority. The study is funded by the Southeastern Norway Regional Health Authority. Results will be published in peer-reviewed journals and disseminated further through scientific conferences, news media and relevant patient interest groups.