International Journal of Epidemiology, Vol 28, 418-427, Copyright © 1999 by International Epidemiological Association
SD Walter, WD King and LD Marrett
BACKGROUND: Although solar radiation is well established as a risk factor
for melanoma, it is less clear how the pattern and timing of exposure to
ultraviolet (UV) radiation might be important. The particular objective of
this study was to evaluate the association of melanoma risk with various
measures of intermittent and chronic exposures to UV radiation, and to
assess how these exposures interact with other risk factors such as skin
type. METHODS: Data were analysed from a large case-control study (583
cases, 608 controls) of malignant melanoma, carried out in southern
Ontario, Canada. RESULTS: Significant risk increases were identified with
several measures of intermittent exposure, including beach vacations in
adolescence and in the past 5 years, previous sunburn, and use of sunbeds
and sunlamps. Chronic exposure, indicated by days of outdoor activity
during adolescence and by occupation in recent adult life, was associated
with significantly reduced risk. Subgroup analyses showed: no major risk
differences by body site of melanoma; stronger association of lentigo
maligna melanoma with intermittent exposure; more pronounced effects of
beach vacations and sunburn in younger subjects; and consistently higher
risks for intermittent exposures among subjects with skin more susceptible
to burning. CONCLUSIONS: The data lend limited support to the hypothesis of
increased risk associated with intermittent UV exposure. The findings
suggest that future studies should take age at diagnosis, host
susceptibility and histological subtype into account.
ARTICLES
Association of cutaneous malignant melanoma with intermittent exposure to ultraviolet radiation: results of a case-control study in Ontario, Canada
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. walter@mcmaster.ca
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