Risk Factors for Melanoma by Body Site

Abstract

It has been hypothesized that cutaneous melanoma at different anatomic sites develops through divergent pathways. We examined this hypothesis prospectively. We followed 152,949 women and 25,204 men free of cancer at baseline for up to 14 years in three large prospective studies. We examined risk factors for melanoma by anatomic location (head or neck, trunk, upper extremity, and lower extremity). Polytomous logistic regression was used to test the difference among risk factors by location of melanoma. A total of 511 incident cases of invasive melanoma (49 head or neck, 188 trunk, 98 upper extremity, and 176 lower extremity) were included in the analysis. Compared with females, males had a higher risk of developing melanoma on the head or neck and trunk. History of severe and painful sunburn was most strongly related to melanoma of upper extremity; individuals with >10 burns had a 6.86-fold (95% confidence interval, 2.62-18.00) higher risk of melanoma of upper extremity compared with those with no burns (P for trend < 0.0001; P for difference by body site = 0.04). Number of moles was most strongly related to melanoma of the trunk; the multivariate relative risk for having >10 moles was 4.67 (95% confidence interval, 3.07-7.11) compared with having no moles (P for trend < 0.0001; P for difference by body site = 0.04). Age, family history of melanoma, and hair color did not statistically differ by anatomic site of the cancer. These data support divergent etiologic pathways of melanoma development by anatomic sites.

A prospective, population‐based study of 40,000 women regarding host factors, UV exposure and sunbed use in relation to risk and anatomic site of cutaneous melanoma

“…22,23 Cho et al 15 similarly reported that ''family history'' was associated with increased risks for CM at all sites.…”

“…Another purpose of the study was to evaluate the risk factors possibly associated with primary tumor sites, based on the theories of divergent pathways to melanoma. 8,12,13,[15][16][17] …”

Estimating the Attributable Fraction for Cancer: A Meta-analysis of Nevi and Melanoma

“…After a review of the study abstracts, we retrieved 80 articles for further assessment, of which 2 reports of cohort studies (9,10), and 47 from case-control studies (refs. 4, 5, 7, 11-54; total = 49) met the eligibility criteria (Fig.…”

“…Common nevi A total of 31 studies provided data on the association between common nevi (whole-body count) and melanoma. An additional eight case-control studies (14,24,32,34,35,39,40,49) and one cohort study (9) did not report on whole-body nevus counts, but rather specific body sites including the arms or legs. A further six studies presented data only for palpable and/or large common nevi (13,19,28,30,31, and 44) and one study did not use quantitative common nevus counts (27); these were also excluded from the analyses (Fig.…”

Skin cancer for dental professionals

“…Recent studies suggest MM of the head and neck is more strongly related to sunburn, and of the trunk to more chronic sun exposure. 28,29 People with fair skin, blue eyes, fair or red hair and those who burn easily are at increased risk of MM, as are those with freckling and benign naevi, especially those with more than 100 such lesions. Large or giant congenital melanocytic lesions confer a high risk, as does the presence of any atypical or dysplastic naevi, or if MM itself has previously occurred.…”