Sunbed use is associated with increased risk of melanoma. Younger people might be more susceptible to the carcinogenic effects of ultraviolet radiation. We investigated the association between sunbed use and risk of early-onset cutaneous malignant melanoma. From the Australian Melanoma Family Study, a multicentre, population-based, case-control-family study, we analysed data for 604 cases diagnosed between ages 18 and 39 years and 479 controls. Data were collected by interview. Associations were estimated as odds ratios (ORs) using unconditional logistic regression, adjusting for age, sex, city, education, family history, skin color, usual skin response to sunlight and sun exposure. Compared with having never used a sunbed, the OR for melanoma associated with ever-use was 1.41 (95% confidence interval (CI) 1.01-1.96), and 2.01 (95% CI 1.22-3.31) for more than 10 lifetime sessions (P trend 0.01 with cumulative use). The association was stronger for earlier age at first use (P trend 0.02). The association was also stronger for melanoma diagnosed when aged 18-29 years (OR for more than 10 lifetime sessions 5 6.57, 95% CI 1.41-30.49) than for melanoma diagnosed when 30-39 years (OR 1.60, 95% CI 0.92-2.77; P interaction 0.01). Among those who had ever used a sunbed and were diagnosed between 18 and 29 years of age, three quarters (76%) of melanomas were attributable to sunbed use. Sunbed use is associated with increased risk of earlyonset melanoma, with risk increasing with greater use, an earlier age at first use and for earlier onset disease.There is mounting evidence that use of sunbeds (indoor tanning) is associated with an increased risk of melanoma at any age. However, younger people might have greater susceptibility to the carcinogenic effects of artificial ultraviolet (UV) radiation. 1 A meta-analysis of 19 studies reported that everuse of sunbeds was associated with 15% increased risk of melanoma [95% confidence interval (CI) 1.00-1.31] compared with never having used a sunbed, although there was no consistent evidence of a dose-response relation. The relative risk of melanoma was greater for those who first used a sunbed before 35 years of age (summary relative risk based on seven studies: 1.75, 95% CI 1.35-2.26). 1 Adolescents and young adults have the highest prevalence of sunbed use, estimated at about 20-40% in the United States and Sweden, 2-6 yet little is known about the association of sunbed use with melanoma diagnosed in young adults since most previous studies have recruited people with melanoma diagnosed at any age. Although the median age of diagnosis of melanoma is about 60 years, 7,8 melanoma is one of the most common cancers and leading causes of cancer death in young adults, [7][8][9] It is of public health importance to determine the risks of melanoma associated with sunbed use in younger people because this risk behavior is increasingly prevalent in developed countries including the United States and Australia, 2,4,10,11 and melanoma incidence rates continue to increase in populations of E...
In 2004-2007 4 independent case-control studies reported evidence that sun exposure might protect against NHL; a fifth, in women only, found increased risks of NHL associated with a range of sun exposure measurements. These 5 studies are the first to examine the association between personal sun exposure and NHL. We report here on the relationship between sun exposure and NHL in a pooled analysis of 10 studies participating in the International Lymphoma Epidemiology Consortium (InterLymph), including the 5 published studies. Ten case-control studies covering 8,243 cases and 9,697 controls in the USA, Europe and Australia contributed original data for participants of European origin to the pooled analysis. Four kinds of measures of self-reported personal sun exposure were assessed at interview. A two-stage estimation method was used in which study-specific odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential confounders including smoking and alcohol use, were obtained from unconditional logistic regression models and combined in random-effects models to obtain the pooled estimates. Risk of NHL fell significantly with the composite measure of increasing recreational sun exposure, pooled OR 5 0.76 (95% CI 0.63-0.91) for the highest exposure category (p for trend 0.01). A downtrend in risk with increasing total sun exposure was not statistically significant. The protective effect of recreational sun exposure was statistically significant at 18-40 years of age and in the 10 years before diagnosis, and for B cell, but not T cell, lymphomas. Increased recreational sun exposure may protect against NHL. ' 2007 Wiley-Liss, Inc.Key words: non Hodgkin lymphoma; personal sun exposure; pooled analysis It was suggested at first that sunlight might increase risk for non-Hodgkin lymphoma (NHL) because of parallel upwards trends in incidence of melanoma and NHL, a positive geographical correlation between incidence rates of NHL and non-melanocytic skin cancer and an increased risk of NHL in people with a history of skin cancer. [1][2][3][4] Four independent studies directly relating personal sun exposure to NHL risk have suggested the opposite however: that sunlight might protect against NHL.5-8 Reduced risks of NHL were associated with increasing sun exposure on non-working days or vacations in an Australian population, 5 more sunbathing, sunburns and sunlamp exposure in the large SCALE study in Sweden and Denmark,6 with greater exposure to the midday summer sun, greater residential ambient UV and greater sunlamp or tanning booth exposure in a US study, 7 and with using sunbeds or sunlamps and taking holidays in a sunny climate in a German study. 8 One such study, which included only women in Connecticut, has found increased risks of NHL associated with a range of sun exposure measurements including having a suntan for less than 3 months a year and a suntan history of more than 60 years, and with increasing duration of spending time in strong sunlight in summer; the increased risk was particularly for chro...
Objective-Sun exposure is the main cause of melanoma in populations of European origin. No previous study has examined the effect of sun exposure on risk of multiple primary melanomas compared with people who have one melanoma.Methods-We identified and enrolled 2,023 people with a first primary melanoma (controls) and 1,125 with multiple primary melanomas (cases) in seven centers in four countries, recorded their residential history to assign ambient UV and interviewed them about their sun exposure.Results-Risk of multiple primary melanomas increased significantly (P < 0.05) to OR = 2.10 for the highest exposure quarter of ambient UV irradiance at birth and 10 years of age, to OR = 1.38 for lifetime recreational sun exposure, to OR = 1.85 for beach and waterside activities, to OR = 1.57 for vacations in a sunnier climate, to OR = 1.50 for sunburns. Occupational sun exposure did not increase risk (OR = 1.03 for highest exposure). Recreational exposure at any age increased risk and appeared to add to risk from ambient UV in early life.Conclusions-People who have had a melanoma can expect to reduce their risk of a further melanoma by reducing recreational sun exposure whatever their age. The same is probably true for a person who has never had a melanoma.
Background 0.6–12.7% of patients with primary cutaneous melanoma will develop additional melanomas. Pathologic features of tumors in patients with multiple primary cutaneous melanomas have not been well described. In this large international multi-center case-control study, we compared the clinicopathologic features of a subsequent melanoma with the preceding (usually the first) melanoma in patients with multiple primary cutaneous melanomas, and with those of melanomas in patients with single primary cutaneous melanomas. Methods Multiple primary melanoma (cases) and single primary invasive melanoma (controls) patients from the Genes, Environment and Melanoma (GEM) study were included if their tumors were available for pathologic review and confirmed as melanoma. Clinicopathologic characteristics of invasive subsequent and first melanomas in cases and invasive single melanomas in controls were compared. Results 473 pairs comprising a subsequent and a first melanoma and 1989 single melanomas were reviewed. Forward stepwise regression modeling in 395 pairs with complete data showed that, compared to first melanomas, subsequent melanomas were: more commonly contiguous with a dysplastic nevus; more prevalent on the head/neck and legs than other sites; and thinner. Compared with single primary melanomas, subsequent melanomas were also more likely to be: associated with a contiguous dysplastic nevus; more prevalent on the head/neck and legs; and thinner. The same differences were observed when subsequent melanomas were compared with single melanomas. First melanomas were more likely than single melanomas to have associated solar elastosis and no observed mitoses. Conclusions Thinner subsequent than first melanomas suggest earlier diagnosis, perhaps due to closer clinical scrutiny. The association of subsequent melanomas with dysplastic nevi is consistent with the latter being risk factors or risk markers for melanoma.
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