Background: Indoor tanning has been only weakly associated with melanoma risk; most reports were unable to adjust for sun exposure, confirm a dose-response, or examine specific tanning devices. A populationbased case-control study was conducted to address these limitations.Methods: Cases of invasive cutaneous melanoma, diagnosed in Minnesota between 2004 and 2007 at ages 25 to 59, were ascertained from a statewide cancer registry; age-matched and gender-matched controls were randomly selected from state driver's license lists. Self-administered questionnaires and telephone interviews included information on ever use of indoor tanning, types of device used, initiation age, period of use, dose, duration, and indoor tanning-related burns. Odds ratios (OR) and 95% confidence intervals (CI) were adjusted for known melanoma risk factors.Results: Among 1,167 cases and 1,101 controls, 62.9% of cases and 51.1% of controls had tanned indoors (adjusted OR 1.74; 95% CI, 1.42-2.14). Melanoma risk was pronounced among users of UVB-enhanced (adjusted OR, 2.86; 95% CI, 2.03-4.03) and primarily UVA-emitting devices (adjusted OR, 4.44; 95% CI, 2.45-8.02). Risk increased with use: years (P < 0.006), hours (P < 0.0001), or sessions (P = 0.0002). ORs were elevated within each initiation age category; among indoor tanners, years used was more relevant for melanoma development.Conclusions: In a highly exposed population, frequent indoor tanning increased melanoma risk, regardless of age when indoor tanning began. Elevated risks were observed across devices.Impact: This study overcomes some of the limitations of earlier reports and provides strong support for the recent declaration by the IARC that tanning devices are carcinogenic in humans. Cancer Epidemiol Biomarkers
Evidence on dietary risk factors for ovarian cancer is inconsistent, but some studies have suggested positive associations with dietary fat, lactose, and cholesterol and negative associations with green and yellow vegetable intake. By using information from the Iowa Women's Health Study, the authors investigated the association of epithelial ovarian cancer with dietary factors in a prospective study of 29,083 postmenopausal women. Dietary information was ascertained via a food frequency questionnaire mailed to participants in 1986. During 10 years of follow-up (1986-1995), 139 of the women developed incident epithelial ovarian cancer. Incidence of the disease was not associated with dietary fat intake. Lactose and cholesterol showed moderately elevated risks. Multivariable-adjusted relative risks for the lowest to highest quartiles of lactose intake were 1.00, 1.38, 1.25, and 1.60 (p for trend = 0.12). For cholesterol, the corresponding values were 1.00, 1.34, 1.86, and 1.55 (p for trend = 0.06). Consumption of eggs was also associated with an increased risk of ovarian cancer. Multivariable-adjusted relative risks for increasing frequency of egg consumption were 1.00 (<1/week), 1.12 (1/week), 2.04 (2-4/week), and 1.81 (>4/week) (p for trend = 0.04). Total vegetable intake was modestly and inversely associated with the risk of ovarian cancer (p for trend = 0.21). Green leafy vegetable intake was more strongly associated with a decreased risk: multivariable-adjusted relative risks for the lowest to highest intake levels were 1.00, 0.80, 0.87, and 0.44 (p = 0.01). These findings are generally in agreement with the results from previous, mostly case-control studies of diet and epithelial ovarian cancer.
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