Distribution of malignant melanoma on the body surface

Abstract

Summary.-The distribution of malignant melanoma among the 4 major body sites (head, upper limb, lower limb and remainder (trunk)) was investigated for 37 white populations. Although UV radiation is generally considered to be the major aetiological agent, it was found that 75% of the tumours occurred on the relatively unexposed body sites. However, the sex differences in the incidence of melanoma at the various sites corresponded in direction and magnitude with the patterns of exposures of the sexes.The greatest difference between the sexes was the higher incidence on the female lower limb (the regular wearing of skirts results in a considerable exposure), and the next largest was the higher incidence on the male trunk (men can remove their shirts easily, but do not do so regularly). The results indicate that UV radiation is a major cause of malignant melanoma, but suggest that the mechanism of induction may be complex. Several hypotheses, as well as the types of additional evidence required, are discussed.

Seasonality of presentation of cutaneous melanoma, squamous cell cancer and basal cell cancer in the Oxford Region

“…The skin site distribution of cutaneous melanoma in the Oxford Region is very similar to that in many other registry-based studies of white populations (Jensen & Bolander, 1980;Crombie, 1981;Muir & Nectoux, 1981;Swerdlow, 1984). The seasonality data from Oxford add to the evidence that there is a marked seasonal pattern, with a summer peak, to cutaneous melanoma presentations in white populations (Malec & Eklund, 1978;Morton & Starr, 1979;Scotto & Nam, 1980;Hinds et al, 1981;Holman & Armstrong, 1981) although one previous study (Elwood & Gallagher, 1983) did not find such seasonality.…”

“…* Registration of cancers is voluntary. The data sources and methods used by the registry have been detailed by Hunt (1976 judged from various indirect measures, appear generally to be high (Doll et al, 1970;Waterhouse et al, 1976Waterhouse et al, , 1982Scott, 1983 Harmonic seasonality of first attendance was tested by the method of Edwards (1961) when this method was applicable. Edwards' test is inappropriate if the sample size is less than 50 (Hewitt et al, 1971) or if the seasonal data do not fit a harmonic curve.…”

Risk Factors for Melanoma by Body Site

“…There have been several case-control studies or case-case comparisons that examined melanoma risk factors with melanoma risk in different body locations (2,(10)(11)(12)(13)(14)(15)(16)(17)(18). However, many of them did not test the difference statistically and did not adjust for multiple risk factors.…”

Distribution of melanoma on the body surface

“…I. K. Crombie (1981) on the distribution of malignant melanoma on the body surface. Unfortunately, the author's calculations of the proportional distribution by site of total body melanocytes may be erroneous.…”