Melanoma and the Sun: The Effect of Swimsuits and a “Healthy” Tan on the Risk of Nonfamilial Malignant Melanoma in Women

Weinstock, Martin A.; Colditz, Graham A.; Willett, Walter C.; Stampfer, Meir J.; Bronstein, Ben R.; Mihm, Martín C.; Speizer, Frank E.

doi:10.1093/oxfordjournals.aje.a116117

Cited by 73 publications

(36 citation statements)

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“…Our findings, arising from the first population-and incidence-based study to evaluate atypical moles in relation to melanoma risk, confirm the importance of host susceptibility, represented by pigmentary factors and the tendency to develop benign or atypical moles, in the etiology of this disease. ' 2005 Wiley-Liss, Inc.Key words: melanoma; moles; atypical moles; pigmentary characteristics; sun sensitivity Numerous epidemiologic studies of melanoma risk have shown a modest to moderate influence of pigmentary factors.1-4 Associations with sunburn or sun exposure are also widely reported, 3,[5][6][7] although findings are inconsistent.8 Over the last 2 decades, in response to clinical reports of multiple benign and atypical moles occurring in nonfamilial melanoma patients, 9 epidemiologic studies have sought to quantify the relationship between these lesions and melanoma risk. Research results have demonstrated strong associations between melanoma risk and benign mole counts, whether self-counted 1 or assessed by examiners.…”

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confidence: 99%

“…1-4 Associations with sunburn or sun exposure are also widely reported, 3,[5][6][7] although findings are inconsistent.…”

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confidence: 99%

“…[1][2][3][4] Associations with sunburn or sun exposure are also widely reported, 3,[5][6][7] although findings are inconsistent. 8 Over the last 2 decades, in response to clinical reports of multiple benign and atypical moles occurring in nonfamilial melanoma patients, 9 epidemiologic studies have sought to quantify the relationship between these lesions and melanoma risk.…”

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confidence: 99%

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Pigmentary characteristics and moles in relation to melanoma risk

Titus-Ernstoff

Perry

Spencer

et al. 2005

Intl Journal of Cancer

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Although benign and atypical moles are considered key melanoma risk factors, previous studies of their influence were small and/or institution-based. We conducted a population-based case-control study in the state of New Hampshire. Individuals of ages 20-69 with an incident diagnosis of first primary cutaneous melanoma were ascertained through the New Hampshire State Cancer Registry. Controls were identified through New Hampshire driver's license lists and frequency-matched by age and gender to cases. We interviewed 423 eligible cases and 678 eligible controls. Host characteristics, including mole counts, were evaluated using logistic regression analyses. Our results showed that pigmentary factors, including eye color (OR = 1.57 for blue eyes compared to brown), hair color (OR = 1.85 for blonde/red hair color compared to brown/black), freckles before age 15 (OR = 2.39 for freckles present compared to absent) and sun sensitivity (OR = 2.25 for peeling sunburn followed by no tan or a light tan and 2.42 for sunburn followed by tan compared to tanning immediately), were related to melanoma risk; these associations held after adjustment for sun-related factors and for moles. In analyses confined to skin examination participants, the covariate-adjusted effects of benign and atypical moles were moderately strong. Compared to 0-4 benign moles, risk increased steadily for 5-14 moles (OR = 1.71), 15-24 moles (OR = 3.55) and 25 moles (OR = 4.33). Risk also increased with the number of atypical moles; compared to none, the ORs for having 1, 2-3, or 4 atypical moles were 2.08, 1.84 and 3.80, respectively. Although risk was highest for those with multiple benign and atypical moles, the interaction was not of statistical significance. Our findings, arising from the first population-and incidence-based study to evaluate atypical moles in relation to melanoma risk, confirm the importance of host susceptibility, represented by pigmentary factors and the tendency to develop benign or atypical moles, in the etiology of this disease. ' 2005 Wiley-Liss, Inc.Key words: melanoma; moles; atypical moles; pigmentary characteristics; sun sensitivity Numerous epidemiologic studies of melanoma risk have shown a modest to moderate influence of pigmentary factors.1-4 Associations with sunburn or sun exposure are also widely reported, 3,[5][6][7] although findings are inconsistent.8 Over the last 2 decades, in response to clinical reports of multiple benign and atypical moles occurring in nonfamilial melanoma patients, 9 epidemiologic studies have sought to quantify the relationship between these lesions and melanoma risk. Research results have demonstrated strong associations between melanoma risk and benign mole counts, whether self-counted 1 or assessed by examiners. 3,10-20 Although several studies have also shown strong associations between atypical moles, the putative melanoma precursors and melanoma risk, these efforts were wholly or in part institution-based and/or involved small numbers of cases. [11][12][13][14][15][16][19][20][21][22...

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confidence: 99%

“…1-4 Associations with sunburn or sun exposure are also widely reported, 3,[5][6][7] although findings are inconsistent.…”

mentioning

confidence: 99%

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confidence: 99%

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Pigmentary characteristics and moles in relation to melanoma risk

Titus-Ernstoff

Perry

Spencer

et al. 2005

Intl Journal of Cancer

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“…The majority of BCCs and of SCCs occur on the chronically sun-exposed skin of the face, although most melanomas occur elsewhere on the body, and the evidence from case-control studies regarding melanomas that occur at common locations has not demonstrated associations between location of sun exposure and location of the melanoma (27)(28)(29). Among patients with xeroderma pigmentosum, NMSCs are more concentrated on the face than melanomas (30).…”

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confidence: 99%

“…Suntans also protect against sunburn, which is associated with melanoma risk (34). There have now been several studies published that suggest that frequent sun exposure may be associated with lower relative risks among those who tan readily (presumably as a result of their developing a photoprotective tan) compared to the relative risks of similar exposures among those who are more sun sensitive and less capable of tanning; however, this hypothesis remains controversial (28,(35)(36)(37)(38).…”

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confidence: 99%

Overview of ultraviolet radiation and cancer: what is the link? How are we doing?

Weinstock

1995

Environ Health Perspect

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Sun exposure has now been established as the most important avoidable cause of nonmelanoma skin cancer (NMSC) and melanoma. With specific reference to melanoma, there are several key issues that remain to be resolved. These include definition of the action spectrum, the importance of systemic effects of sun exposure, whether a tan is protective, the risk of tanning booth exposures, and the efficacy of sunscreens. Also the role, if any, of sun exposure in noncutaneous malignancies remains to be established. Melanoma incidence and mortality have increased dramatically over the past several decades, but these increases have now slowed, and for mortality among those 15 to 45 years of age, decreasing rates are now observed. Improving the coverage of the Surveillance, Epidemiology, and End Results (SEER) registries by requiring pathology laboratories in non-SEER areas to report cancers among SEER area residents will allow correct interpretation of these trends in the future at minimal cost. The available data on trends in NMSC incidence and mortality are suboptimal but suggest a pattern of declining mortality despite increasing incidence. Trends in NMSC morbidity have not been defined. Establishing NMSC registries in a few diverse sentinel areas would allow more reliable inference and monitoring. Techniques are being developed for reducing sun exposures and increasing early detection of skin cancers in the general population, but improved monitoring of incidence, mortality, and morbidity is required to monitor the effects of current and future ozone depletion and to evaluate prevention and early detection measures. -Environ Health Perspect 103(Suppl 8): 251-254 (1995)

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