Suntan, sunburn, and pigmentation factors and the frequency of acquired melanocytic nevi in children. Similarities to melanoma: the Vancouver Mole Study

Gallagher, Richard H.

doi:10.1001/archderm.126.6.770

Cited by 107 publications

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“…The median count of melanocytic nevi Ն2 mm in diameter was 11 (25th-75th percentiles, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], and the corresponding median density was 7.1 (25th-75th percentiles, 3.2-14.3). The median nevus density was higher among boys than girls (7.72 vs. 6.77) with a relative geometric mean adjusted for phenotypic characteristics of 1.11 (95% CI 1.03-1.19).…”

Section: Resultsmentioning

confidence: 99%

“…13,28 Data from cross-sectional studies suggest that, while the number of nevi increases progressively with age up to adulthood, the ratio of the number of nevi to the body surface area (usually referred to as "nevus density") reaches a plateau between ages 9 and 14, pointing to nevus density as a possible genetic trait. 10,12,14 However, cross-sectional studies, especially if conducted over broad age ranges, may reflect cohort differences in nevus prevalence and degree of exposure to purported risk factors, e.g., ultraviolet light radiation, rather than and in addition to genuine age effects. The relation between the density of nevi in childhood and the density in adult life has not been fully elucidated.…”

Section: Resultsmentioning

confidence: 99%

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The density of melanocytic nevi correlates with constitutional variables and history of sunburns: A prevalence study among Italian schoolchildren

Carli

Naldi

Lovati

et al. 2002

Intl Journal of Cancer

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In several studies from northern Europe, north America and Australia, melanocytic nevi are correlated with pigmentary traits and with intense sun exposure in a way similar to malignant melanoma. However, it is unclear if these data can be extrapolated to populations in other geographic locations and with different prevalent phenotypes. Our study was conducted among schoolchildren aged 13-14 years in 16 Italian cities. The parents of 3,127 children of a total of 3,160 (99%) consented to our study. A structured questionnaire was used to collect information about sun exposure and lifetime history of sunburns. Children were also examined by trained dermatologists to assess pigmentary traits and to make a count of melanocytic nevi. The median nevus density was higher among boys than girls. Areas that are usually chronically exposed to the sun exhibited a higher density of nevi compared to intermittently and rarely exposed areas. A higher density of nevi was found in children with lighter skin, blond hair and blue eyes. Red-haired children had a remarkably lower nevus density compared to the other color categories. The density of nevi increased with an increased number of reported episodes of sunburns. The results concerning nevi >6 mm in diameter paralleled those obtained for the total nevus density. However, at variance with total nevus density, a significant relation was also observed between larger nevi and freckling. Our study confirms that, in Italian schoolchildren, there is a relation between pigmentary traits, history of sunburns and the density of melanocytic nevi. Melanocytic nevi and malignant melanoma share a similar risk factor profile. © 2002 Wiley-Liss, Inc. Key words: melanocytic nevi; malignant melanoma; sunburns; pigmentary traits; epidemiology; South European populationA large number of common melanocytic nevi and the presence of large atypical nevi are strongly associated with cutaneous malignant melanoma. [1][2][3][4][5][6] The biologic correlates of such an association are still poorly understood, but it is plausible that factors that affect the density of melanocytic nevi may also influence the development of malignant melanoma later in life. Risk factors for malignant melanoma have been widely explored in epidemiologic studies and, besides the number of nevi, include pigmentary traits, e.g., light skin and hair color, propensity to sunburns and indicators of intense and intermittent exposure to solar ultraviolet (UV) radiation especially during early life. 7-8 A number of epidemiologic studies confirm that the number of acquired melanocytic nevi is correlated with pigmentary traits, similar to those associated with malignant melanoma, and with intense sun exposure and history of sunburns. 9 -19 Data concerning factors associated with melanocytic nevi have been mostly derived from populations in northern Europe, north America and Australia, and it is unclear if these data can be extrapolated to populations in other geographic locations and with different prevalent phenotypes. The aim of our s...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The density of melanocytic nevi correlates with constitutional variables and history of sunburns: A prevalence study among Italian schoolchildren

Carli

Naldi

Lovati

et al. 2002

Intl Journal of Cancer

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“…In several case-control studies of melanoma in Australia (Green et al, 1986;Armstrong and English, 1988); Europe (Swerdlow et al, 1986;Osterlind et al, 1988;Grob et al 1990;Augustsson et al, 1991) and North America (Gallagher et al 1990, Holly et al 1987, large numbers of common and atypical naevi have been the strongest risk factors found for this tumour. Naevus count studies have shown that UVR exposure probably influences the expression of the naevus phenotype in children (Fritschi et al, 1994;Harrison et al 1994;Kelly et al, 1994), but this has not been formally shown in adults.…”

Section: Discussionmentioning

confidence: 99%

“…Atypical naevi and large numbers of common naevi are the most powerful predictors for an increased risk of melanoma, with significant relative risks shown in Australia (Holman and Armstrong, 1984a) as well as Sweden, Denmark, UK, Canada, USA and France (Holly et al, 1987;Osterlind et al, 1988;Augustsson et al, 1991;Gallagher et al, 1990; Grob et al, 1990;Bataille et al, 1996). The incidence of melanoma in Australia is thought to be attributable to high levels of sun exposure, but it is not entirely clear to what extent exposure to ultraviolet radiation affects the development of common and atypical naevi.…”

mentioning

confidence: 99%

The association between naevi and melanoma in populations with different levels of sun exposure: a joint case-control study of melanoma in the UK and Australia

Bataille¹,

Grulich²,

Sasieni³

et al. 1998

Br J Cancer

101

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Summary Two case-control studies were set up to investigate the relationship between melanocytic naevi and risk of melanoma and to compare the naevus phenotype in two countries exposed to greatly different levels of sun exposure and different melanoma rates. In England 117 melanoma cases and 163 controls were recruited from the North-East Thames Region and 183 melanoma cases and 162 controls from New South Wales, Australia. Each subject underwent a whole-body naevus count performed by the same examiner in each country. Relative risks associated with melanocytic naevi in each country were calculated with comparison of naevus data in controls between Australia and England. Atypical naevi were strong risk factors for melanoma in both countries: the odds ratio (OR) for three or more atypical naevi was 4.6 (95% Cl 2.0-10.7) in Australia compared with 51.7 (95% Cl 6.5-408.4) in England. Common naevi were also significant risk factors in Australia and England with similar odds ratios in the two countries. Prevalence of atypical naevi was greater in Australian controls than in English controls: OR 9.7 (95% Cl 1.2-81.7) for three or more atypical naevi in Australia compared with England. For young age groups, the median number of common naevi was greater in Australia than in the UK, whereas for older individuals this difference in naevi number between the two countries disappeared. The prevalence of naevi on non-sun-exposed sites in controls was not significantly different between the two countries. The atypical mole syndrome (AMS) phenotype was more prevalent in Australian controls (6%) than in English controls (2%). The results of this study support the role of sun exposure in the induction of atypical naevi in adults. There was a trend towards stronger risk factors associated with atypical naevi in England compared with Australia. The atypical mole syndrome, usually associated with a genetic susceptibility to melanoma, was more common in Australia than in England, suggesting genetic environmental interactions with the possibility of phenocopies induced by sunlight.

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“…The role of sunburns as risk factors for MN has been discussed controversially in literature. Sunburns were found to be associated significantly with the number of MN in children, 10,12,13,17,29,31,39,50 yet some studies could not demonstrate such an association. 19,28 In contrast to an earlier cross-sectional analysis, 19 the present longitudinal multivariate analysis identified history and the extent and severity of sunburns as significant risk factors for the development of new MN.…”

Section: Table I -Basic Description Of 1232 German Children and Resumentioning

confidence: 99%

Risk factors of incident melanocytic nevi: A longitudinal study in a cohort of 1,232 young German children

Bauer

Büttner

Wiecker

et al. 2005

Intl Journal of Cancer

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The number of melanocytic nevi is the most important independent risk factor for cutaneous melanoma. Aim of our study was to add information to the controversial discussion on the role of chronic-moderate and intermittent-high sun exposure and sunburns for the development of melanocytic nevi by the use of a large longitudinal study. A longitudinal study with a 3-year follow-up was conducted in 1,232 young children 2-7 years of age attending 78 public nursery schools in Bochum and Stuttgart, Germany. Total body nevus counts, assessment of pigmentary features and nevus counts on arms of parents were carried out. Parents underwent a standardized interview concerning sun exposure, sunburns and sun-protective behavior. Applying multiple linear regression analysis higher numbers of incident nevi were associated with host factors like light skin complexion (skin Type II vs. IV, p ‫؍‬ 0.022) and freckling of the face (p < 0.001), with parental factors like nevus counts on mothers' (p < 0.001) and fathers' (p ‫؍‬ 0.004) arms and at least one parent being of German descent (p ‫؍‬ 0.006), and with environmental factors like intermittent-high sun exposure during holidays (p < 0.001) and chronic-moderate ultraviolet radiation at home (p ‫؍‬ 0.007). Sunburns were a significant risk factor for nevus development (p ‫؍‬ 0.005). Total cumulative sun exposure seems to be the crucial environmental risk factor for the development of nevi, whether the child is exposed to chronicmoderate or intermittent-high ultraviolet light doses. Public health education should focus primarily on avoiding sun exposure especially in children with fair skin and parents with high nevus counts. The total number of melanocytic nevi (MN) on the body is known to be the strongest intrinsic risk factor for the development of cutaneous melanoma (CM). 1-5 Moreover, MN were considered to be precursor lesions of a substantial proportion of CM. 6,7 Case control studies on risk factors for CM in adults are influenced by recall bias. 8 Childhood is a period of particular susceptibility to the carcinogenic effects of solar radiation. 9 Thus, studies on MN in children might give new insights into the pathogenesis of CM.To date, numerous cross-sectional studies have been published identifying risk factors for MN development in children. 10 -19 Studies yielded partly contradicting results to important points like the amount and intensity of sun exposure needed for MN development and the role of sunburns. Few longitudinal studies exist that investigated risk factors for incident MN. 20 -24 Such studies might give a better control of the influence of environmental factors and confounders. Our present study longitudinally investigated risk factors for the development of MN in a cohort of 1,232 German kindergarten children, 2-7 years of age, followed-up over a 3-year period. Material and methods ParticipantsOur analysis utilized data of children who participated in a randomized controlled trial set up to investigate whether educational intervention and the provision of ...

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Suntan, sunburn, and pigmentation factors and the frequency of acquired melanocytic nevi in children. Similarities to melanoma: the Vancouver Mole Study

Cited by 107 publications

References 0 publications

The density of melanocytic nevi correlates with constitutional variables and history of sunburns: A prevalence study among Italian schoolchildren

The density of melanocytic nevi correlates with constitutional variables and history of sunburns: A prevalence study among Italian schoolchildren

The association between naevi and melanoma in populations with different levels of sun exposure: a joint case-control study of melanoma in the UK and Australia

Risk factors of incident melanocytic nevi: A longitudinal study in a cohort of 1,232 young German children

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