Sun exposure and malignant melanoma among susceptible individuals.

Abstract

The purpose of this case-control study was to identify susceptible subgroups, primarily based on pigmentary characteristics, at higher risk of developing melanoma when exposed to the sun. The study group, which was interviewed from 1979 to 1982, consisted of 289 consecutive patients with melanoma and 527 randomly selected controls without cancer. In general, the risk of melanoma associated with sun exposure was greater for individuals expected to be susceptible on the basis of poor ability to tan, but not other pigmentary traits. There were, in addition, some noteworthy interactions between age and sun exposure.Among subjects with poor tanning ability, the risk of melanoma associated with outdoor occupation was more than 3-fold [odds ratio (OR) = 3.31 compared to indoor occupation. In contrast, the analogous OR was much less elevated among subjects with a good ability to tan (OR = 1.5). Mixed indoor and outdoor job exposure was protective among good tanners (OR = 0.80), but not among poor tanners (OR = 1.5). A similar pattern was seen for recreational sun exposure and, when applying multiple logistic regression, for the patient's overall subjective assessment of his lifetime sun exposure. However, quantitative assessment of average hours of sun exposure did not prove to be a good indicator of melanoma risk, even among susceptible individuals. A history of severe sunburn with blistering was associated with nearly 3-fold risk among poor tanners (OR = 2.9) but was protective among good tanners (OR = 0.79). A history of nonmelanoma skin cancer or solar keratosis was a very strong risk factor (OR = 7.3), which, however, did not significantly differ in magnitude among susceptibility subgroups.

Instrumental Measurements of Skin Color and Skin Ultraviolet Light Sensitivity and Risk of Cutaneous Malignant Melanoma: A Case-Control Study in an Italian Population

“…It is unlikely that our findings could be attributable to greater misclassification of L* among subjects with low total sun exposure, since results were similar for L* and MED and measurements were made on the buttock, an area that is not affected by sun exposure. In addition, these findings are in agreement with those of other case-control studies (63)(64)(65)(66)(67)(68) that measured sun exposure and sun sensitivity in a number of different ways. This suggests that skin sensitivity in the presence of sun exposure is an important risk factor for CMM and that reduction of sun exposure could be especially beneficial for ultraviolet-sensitive persons.…”

Effect of Intermittent Exposure to Sunlight on Melanoma Risk among Indoor Workers and Sun-Sensitive Individuals

“…Both Weinstock et al (7 tive individuals. This modification of the and Dubin et al (8) found higher risks of melanoma risk by the ability to tan and the melanoma among sun-sensitive persons opportunity for gradual tanning has only than among more sun-resistant persons. been addressed in a few studies (2,3,7,8).…”

Sunburns and Risk of Cutaneous Melanoma: Does Age Matter? A Comprehensive Meta-Analysis

“…Sun sensitivity characteristics are widely accepted as risk factors for CM, including eye, hair and skin color, tendency to sunburn and inability to tan (20, 76, 86). Lighter complexion as measured by both Fitzpatrick skin-type (21, 33, 41) and self-reported skin color (fair, medium, or dark) (87–89) appear to be the most consistent risk factors for CM.…”