A design for cancer case–control studies using only incident cases: experience with the GEM study of melanoma

Begg, Colin B.; Hummer, Amanda; Mujumdar, Urvi; Armstrong, Bruce K.; Kricker, Anne; Marrett, Loraine D.; Millikan, Robert C.; Gruber, Stephen B.; Culver, Hoda Anton; Zanetti, Roberto; Gallagher, Richard P.; Dwyer, T; Rebbeck, Timothy R.; Busam, Klaus J.; From, Lynn; Berwick, Marianne

doi:10.1093/ije/dyl044

Cited by 69 publications

(118 citation statements)

References 32 publications

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“…Controls had a first invasive primary melanoma diagnosed in the first 6 or more months of 2000 and cases had a second or higher order invasive or in situ melanoma diagnosed in [2000][2001][2002][2003] in New South Wales, North Carolina and Ontario and in 1998-2003 in British Columbia, California, New Jersey and Tasmania [6].…”

Section: Subjectsmentioning

confidence: 99%

“…Most who did not participate refused (30% each of eligible cases and controls who were approached) or could not be contacted (12% and 9%); few were barred by physician refusal (4% each of cases and controls) or had died (4% each of cases and controls). Ninety-four subjects were eligible and were included as both a case and a control [6].…”

Section: Subjectsmentioning

confidence: 99%

“…Cases (87% were aged 50+) were substantially older than controls (65% aged 50+) because both were sampled from people with incident melanomas (see Begg et al [6]). Comparison of analyses that adjusted for age in 5-year age groups, age in decades and age as a continuous variable showed that age as a continuous variable provided the best control of confounding by age.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…The Genes, Environment and Melanoma Study (GEM) is the first study designed to be able to systematically evaluate the effects of sun exposure on risk of multiple primary melanomas in people who have already had a melanoma [6] and we report in this paper the first results of sun exposure analyses. We address ambient UV irradiance and reported sun exposure hours over life and in specific periods of life and their interactions in determining risk of multiple primary melanomas.…”

Section: Introductionmentioning

confidence: 99%

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Ambient UV, personal sun exposure and risk of multiple primary melanomas

Kricker

Armstrong

Goumas

et al. 2007

Cancer Causes Control

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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.

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Section: Subjectsmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ambient UV, personal sun exposure and risk of multiple primary melanomas

Kricker

Armstrong

Goumas

et al. 2007

Cancer Causes Control

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108

101

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“…A full description of the GEM study design has been published separately [10][11][12]. In this report, only the University of Michigan subjects were used, since supplemental data regarding medication usage was not collected from other centers.…”

Section: Methodsmentioning

confidence: 99%

Non-steroidal anti-inflammatory drugs and the risk of melanoma

Jeter

Bonner

Johnson

et al. 2005

JCO

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Because nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit tumor growth in vitro, we investigated the association between NSAIDs and melanoma to determine if there was epidemiologic evidence of a chemopreventive effect from these medications. Three hundred twenty-seven subjects with incident melanoma and 119 melanoma-free controls completed a structured interview assessing melanoma risk factors. The unadjusted odds ratio (OR) for use of nonaspirin NSAIDs was 0.58 (95% CI 0.31-1.11), in a comparison of subjects with melanoma to controls. After adjustment for melanoma risk factors, the OR was 0.71 (95% CI 0.23-2.02). Aspirin users had an unadjusted OR of 0.85 (95% CI 0.45-1.69) and an adjusted OR of 1.45 (95% CI 0.44-4.74). In this pilot study, we found no evidence of a significant association between analgesic use and melanoma risk when potential confounders are assessed. Based on conflicting reports in the literature, meta-analysis may be appropriate.

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Survival for Patients With Single and Multiple Primary Melanomas

et al. 2013

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Objective Little is known about survival after a diagnosis of a second or higher order (multiple) primary melanoma. We aimed to determine whether survival after diagnosis was better in patients with multiple primary melanomas (MPM) than with single primary melanomas (SPM), as suggested in a recent study. Design Survival analysis with median follow-up of 7.6 years (range 0.4-10.6). Setting The Genes, Environment and Melanoma (GEM) study enrolled incident cases of melanoma notified to population-based cancer registries in Australia, Canada, Italy and the USA. MPM were ascertained over a longer period than SPM. Participants 2372 patients with SPM and 1206 with MPM. Main outcome measures Melanoma-specific fatality hazard ratios (HR) and confidence intervals (CI) associated with clinical and pathologic characteristics of SPM, MPM and both together in Cox regression models. Results Thickness was the main determinant of fatality (HR for >4mm=7.68, 95% CI 4.46 to 13.23); other independent predictors were ulceration, mitoses and scalp location. After adjustment for these other predictors, there was little difference in fatality between MPM and SPM (HR for MPM relative to SPM=1.24, 95% CI 0.91 to 1.69; P = .18). Thicker SPM, however, had higher fatality (HR for >4mm=13.56, 95% CI 6.47-28.40) than thicker MPM (HR for >4mm=2.93, 95% CI 1.17-7.30). Conclusion While overall fatalities from SPM and MPM were similar, relative fatality for thick SPM was greater than for thick MPM. This finding may offer support for a difference in outcome between patients with SPM and MPM that is worth further exploration.

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A design for cancer case–control studies using only incident cases: experience with the GEM study of melanoma

Abstract: Patients with a second or subsequent primary cancer of a single type represent a potentially valuable and under-utilized resource for the study of cancer aetiology.

Cited by 69 publications

References 32 publications

Ambient UV, personal sun exposure and risk of multiple primary melanomas

Ambient UV, personal sun exposure and risk of multiple primary melanomas

Non-steroidal anti-inflammatory drugs and the risk of melanoma

Survival for Patients With Single and Multiple Primary Melanomas

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