Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012

Abstract

Ultraviolet radiation (UVR) is a strong and ubiquitous risk factor for cutaneous melanoma, emitted naturally by the sun but also artificial sources. To shed light on the potential impact of interventions seeking to reduce exposure to UVR in both high and low risk populations, we quantified the number of cutaneous melanomas attributable to UVR worldwide. Population attributable fractions and numbers of new melanoma cases in adults due to ambient UVR were calculated by age and sex for 153 countries by comparing the current melanoma burden with historical data, i.e., the melanoma burden observed in a population with minimal exposure to UVR. Secondary analyses were performed using contemporary melanoma incidence rates in dark-skinned African populations with low UVR susceptibility as reference. Globally, an estimated 168,000 new melanoma cases were attributable to excess UVR in 2012, corresponding to 75.7% of all new melanoma cases and 1.2% of all new cancer cases. This burden was concentrated in very highly developed countries with 149,000 attributable cases and was most pronounced in Oceania, where 96% of all melanomas (representing 9.3% of the total cancer burden) were attributable to excess UVR. There would be approximately 151,000 fewer melanoma cases worldwide were incidence rates in every population equivalent to those observed in selected low-risk (dark-skinned, heavily pigmented) reference populations. These findings underline the need for public health action, an increasing awareness of melanoma and its risk factors, and the need to promote changes in behavior that decrease sun exposure at all ages.

The 2018 World Health Organization Classification of Cutaneous, Mucosal, and Uveal Melanoma: Detailed Analysis of 9 Distinct Subtypes Defined by Their Evolutionary Pathway

“…These variants represent the major patterns of melanoma in skin that is susceptible to CSD and is exposed to sunlight, such as in populations of northern European ancestry, especially those living in sunny climates like Australia, New Zealand, and the United States, or traveling on sun-seeking vacations. 17,18 It is the growing and changing RGP stage of melanoma that gives rise to the characteristic signs of early melanoma, described in the well-known ABCDE mnemonic. 19,20 ''A'' stands for ''asymmetry,'' where one half of the lesion, for example, differs from the other half in shape or color.…”

Benefit–Cost Analysis of the Danish Sun Safety Campaign 2007–2015: Cost Savings from Sunburn and Sunbed Use Reduction and Derived Skin Cancer Reductions 2007–2040 in the Danish Population

“…A total of 2250 new cases of melanoma cancer and 14,250 new cases of keratinocyte cancer were registered in 2015, and 28,000 and 152,000 persons, respectively, had a previous melanoma or keratinocyte skin cancer diagnosis in a Danish population of 5,500,000 [5,7]. It is estimated that in Denmark, more than 90% of skin cancers could be prevented [8,9], meaning there is large potential for the prevention of excessive UV exposure in Denmark.…”

Ozone depletion, ultraviolet radiation, climate change and prospects for a sustainable future

“…Melanoma accounts for less than 5% of skin cancers, but has a much higher mortality than other skin cancers and accounts for approximately 60,000 deaths worldwide each year. Exposure to UV radiation accounts for 60-96% of the risk of developing cutaneous malignant melanoma in light-skinned populations; globally, ca.168,000 new melanomas in 2012 were attributable to 'excess' exposure to UV radiation (above that of a historical population with minimal exposure) corresponding to 76% of all new melanoma cases 60 . To date, stratospheric ozone depletion is expected to increase these numbers by a few percent 61 when integrated over a lifetime of exposure.…”