Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls

Abstract

Background Melanoma risk is related to sun exposure; we have investigated risk variation by tumour site and latitude.Methods We performed a pooled analysis of 15 case–control studies (5700 melanoma cases and 7216 controls), correlating patterns of sun exposure, sunburn and solar keratoses (three studies) with melanoma risk. Pooled odds ratios (pORs) and 95% Bayesian confidence intervals (CIs) were estimated using Bayesian unconditional polytomous logistic random-coefficients models.Results Recreational sun exposure was a risk factor for melanoma on the trunk (pOR = 1.7; 95% CI: 1.4–2.2) and limbs (pOR = 1.4; 95% CI: 1.1–1.7), but not head and neck (pOR = 1.1; 95% CI: 0.8–1.4), across latitudes. Occupational sun exposure was associated with risk of melanoma on the head and neck at low latitudes (pOR = 1.7; 95% CI: 1.0–3.0). Total sun exposure was associated with increased risk of melanoma on the limbs at low latitudes (pOR = 1.5; 95% CI: 1.0–2.2), but not at other body sites or other latitudes. The pORs for sunburn in childhood were 1.5 (95% CI: 1.3–1.7), 1.5 (95% CI: 1.3–1.7) and 1.4 (95% CI: 1.1–1.7) for melanoma on the trunk, limbs, and head and neck, respectively, showing little variation across latitudes. The presence of head and neck solar keratoses was associated with increased risk of melanoma on the head and neck (pOR = 4.0; 95% CI: 1.7–9.1) and limbs (pOR = 4.0; 95% CI: 1.9–8.4).Conclusion Melanoma risk at different body sites is associated with different amounts and patterns of sun exposure. Recreational sun exposure and sunburn are strong predictors of melanoma at all latitudes, whereas measures of occupational and total sun exposure appear to predict melanoma predominately at low latitudes.

Systematic review of studies investigating the association between dietary habits and cutaneous malignant melanoma

“…In the scientific literature a great number of publications support the causation of CMM by UV radiation exposure. The past 50 years have added both quantity and quality to epidemiological evidence and, most recently, provided direct evidence that sun exposure is the cause of mutations in critical tumor suppressor genes in melanoma [1,[10][11][12][13][14][15][16][17][18].…”

‘I am not someone who gets skin cancer’: risk, time and malignant melanoma

“…However, the predictive power of ultraviolet radiation exposure as a risk factor 7 for melanoma should not be exaggerated. An odds ratio of 1.7 has been estimated from a pooled analysis of studies undertaken across global latitudes for greater recreational sun exposure in relation to melanoma of the trunk and legs, the most powerful effect (Chang et al, 2009). A similar odds ratio has been derived from a systematic review of studies of sunbed use before the age of 35 (Green et al, 2007).…”

Solar UV exposure in construction workers in Valencia, Spain

“…Some recent studies show that the incidence of melanoma is related to both altitude and latitude (Aceituno et al 2011;Boniol et al 2005;Chang et al, 2009;de Vries et al, 2004;Downs et al, 2011;Micu et al, 2011;Moehrle and Garbe, 1999;Pfeifer et al, 2006). Due to its geographical situation, for most of the year the Valencia Region (Spain) receives large doses of UVR.…”