„Nasze wyniki sugerują, że badania przesiewowe i edukacja w ramach NCI Familial Melanoma Study mogą poprawić wczesne wykrywanie czerniaka w rodzinach ze skłonnością do czerniaka” – powiedział dr Michael Sargen, dermatolog z National Cancer Institute (NCI), autor analizy powyższego badania, które zostało przeprowadzone w latach 1976-2014.
Jak wyjaśnił dr Sargen, w procesie rekrutacji, jak również podczas kolejnych wizyt, uczestnikom wykonywano badanie całego ciała w kierunku czerniaka oraz zdjęcia całego ciała ze zbliżeniami potencjalnie problematycznych znamion. Ponadto edukowano ich na temat pojawienia się tej choroby oraz strategii ochrony skóry przed uszkodzeniami spowodowanymi promieniowaniem ultrafioletowym (UV). Zalecono im również coroczne wizyty kontrolne u dermatologa i przeprowadzenie badań przesiewowych całego ciała.
Celem analizy dr. Sargena było porównanie różnicy w zakresie grubości czerniaka i stadium guza wśród uczestników ze zdiagnozowanym czerniakiem przed i po zakwalifikowaniu do badania. Jak wyjaśnił dermatolog, grubość guza, czyli jego głębokość pod powierzchnią skóry, ma związek ze zwiększonym ryzykiem zgonu w wyniku czerniaka.
W analizie badacze wzięli również pod uwagę grubość guza uczestników badania w stosunku do średniej grubości guza w populacji ogólnej. Wykorzystali w tym celu dane z Surveillance, Epidemiology i rejestrów wyników końcowych (SEER).
Jak wykazała analiza, w badaniu NCI Familial Melanoma Study odnotowano łącznie 293 przypadków czerniaka. 246 z nich wykryto w kohorcie przed badaniem, natomiast 47 przypadków w kohorcie prospektywnej, czyli po rozpoczęciu badań.
Analiza dr. Sargena polegała na ocenie, jak czynniki stosowane podczas badania NCI Familial Melanoma Study wpłynęły na grubość czerniaka i stadium nowotworu w momencie rozpoznania. Naukowcy biorąc pod uwagę wiek i płeć wykazali, iż osoby w kohorcie prospektywnej miały istotnie cieńsze czerniaki w porównaniu z przypadkami w kohorcie przed badaniem (odpowiednio 0,6 mm w porównaniu z 1,1 mm). Dodatkowo, istotne było również to, że przypadki czerniaka wykryte po rozpoczęciu badań były diagnozowane znacznie częściej we wczesnym stadium T1 (83 proc.) w stosunku do przypadków w kohorcie przed badaniami (40 proc.).
– Grubość czerniaka w momencie rozpoznania w Stanach Zjednoczonych zmniejsza się od 1973 r., kiedy zaczęliśmy śledzić takie dane – wyjaśnił Sargen.
Eksperci wykazali również, że grubość guza wśród członków rodzin ze skłonnością do czerniaka w porównaniu do szacunkowej grubości guza ogólnej populacji Stanów Zjednoczonych, jest cieńsza niż przewidywano.
– Sugeruje to, że tendencja spadkowa grubości czerniaka obserwowana w populacji ogólnej nie wyjaśnia w pełni zmniejszenia grubości obserwowanego w rodzinach ze skłonnością do czerniaka, a długoterminowy nadzór może pomóc we wcześniejszym rozpoznaniu czerniaka u osób z wysokim zagrożeniem. Nasze wyniki sugerują, że badania przesiewowe i edukacja w ramach NCI Familial Melanoma Study mogą poprawić wczesne wykrywanie czerniaka w rodzinach ze skłonnością do czerniaka – powiedział Sargen.
Wyniki analizy badania NCI Familial Melanoma Study zostały opublikowane w czasopiśmie „Cancer Epidemiology, Biomarkers & Prevention”.
Źródło: PAP
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