Country of origin, age at migration and risk of cutaneous melanoma: A migrant cohort study of 1,100,000 Israeli men

Abstract

Cutaneous melanoma (CM) is a common cancer with increasing incidence in many parts of the world where light-skinned populations live. We conducted a large-scale nationally representative migrant cohort study to assess country of origin and age at migration as predictors of CM, controlling for possible confounders. 3.55-4.67) and Israeli origin (HR 5 2.92, 95% CI: 2.25-3.79) compared to N. African/Asian origin, adjusted for year of birth, years of education, residential socio-economic position, rural residence and body surface area (or height). Among those of European origin, the adjusted risk was significantly lower for those who immigrated after the age of 10 years (HR 5 0.58, 95% CI: 0.45-0.73) but not for younger ages (HR 5 1.02, 95% CI 0.84-1.23) compared to Israeli born. The high rates of CM among men of European origin and the almost twofold lower risk among those immigrating after age 10 provide solid support for the deleterious role of childhood sun exposure as a risk factor for melanoma. These findings will serve in directing public health and research efforts.Cutaneous melanoma (CM) is a common and potentially lethal cancer with increasing rates in many parts of the world, where light-skinned populations live. 1 The rise in incidence is thought to be linked to changing sun exposure patterns, although many aspects of the etiology of CM are not understood or are poorly quantified. 2 Both genetic and environmental factors are related to the pathogenesis of melanoma. Although not all melanomas are sun related, there is clear and convincing evidence that sun exposure, and more specifically ultra-violet (UV) exposure, is a major environmental cause of melanoma, especially in high-risk populations. 3 Melanoma incidence and mortality among Caucasians correlate with latitude of residence and dose of UV radiation, the highest rates being nearest the equator. 3 In areas as geographically diverse as the United States, New Zealand and Australia, the incidence of melanoma is greater at latitudes closer to the equator. However, in the United States, data from 1992 to 2001 demonstrate that the latitude gradient applies only to non-Hispanic whites. 4 Varying CM incidence rates (highest in Australia, New Zealand, white populations in North America/Europe and the Jewish population in Israel) are most likely due to the combination of levels of sun exposure and innate susceptibility. 5 Known risk factors for CM include multiple or atypical nevi, family history, skin phenotype (such as skin pigmentation, hair and eye color), premalignant and skin cancer lesions and actinic damage

Childhood Body Size and the Risk of Malignant Melanoma in Adulthood

“…In agreement with our identified height-MM association, a study of Israeli adolescents (ages 16–19 years) found that greater height was a risk factor for MM (31). Additionally, BSA was also found to be associated with MM risk (31).…”

“…In agreement with our identified height-MM association, a study of Israeli adolescents (ages 16–19 years) found that greater height was a risk factor for MM (31). Additionally, BSA was also found to be associated with MM risk (31). In contrast, in a study of American agricultural workers which used self-reported heights and weights upon enrollment plus recalled weight at age 20 years, Dennis et al (32) did not find associations between height and MM.…”

Association between in-vitro fertilization, birth and melanoma

“…In an attempt to address this problem, we included country of birth in the Table 3 Age-adjusted Cox regression analysis: estimated hazard ratios for birth, age at first birth and parity in women exposed and not exposed to in-vitro fertilization a regression models. Country of birth has been shown to be associated with the risk of melanoma [41][42][43] as it represents an aggregate measure of an individual's skin type, cultural attitudes to sun exposure and potential sun exposure during early life. We found no evidence for confounding by this variable.…”

Risk factors associated with gastroenteropancreatic neuroendocrine tumors in a cohort of 2.3 million Israeli adolescents

“…Within the framework of a large cohort study, sociodemographic and anthropometric data obtained at age 17 were found to be associated with subsequent outcomes such as cancer and cardiometabolic diseases. [22][23][24][25][26][27][28][29][30][31][32][33][34] In the current study, we evaluated the association of baseline adolescent anthropometric and sociodemographic variables with the incidence of GEP-NET.…”