Skip Navigation



IJE Advance Access published online on April 8, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyp166
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrowOA All Versions of this Article:
38/3/814    most recent
dyp166v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Chang, Y.-m.
Right arrow Articles by Newton-Bishop, J. A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Chang, Y.-m.
Right arrow Articles by Newton-Bishop, J. A
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2009; all rights reserved.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org Published by Oxford University Press on behalf of the International Epidemiological Association.

Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls

Yu-mei Chang1,*, Jennifer H Barrett1, D Timothy Bishop1, Bruce K Armstrong2, Veronique Bataille3,4, Wilma Bergman5, Marianne Berwick6, Paige M Bracci7, J Mark Elwood8, Marc S Ernstoff9, Richard P Gallagher8, Adèle C Green10, Nelleke A Gruis5, Elizabeth A Holly7, Christian Ingvar11, Peter A Kanetsky12, Margaret R Karagas13, Tim K Lee8, Loïc Le Marchand14, Rona M Mackie15, Håkan Olsson16, Anne Østerlind17, Timothy R Rebbeck12, Peter Sasieni18, Victor Siskind10, Anthony J Swerdlow19, Linda Titus-Ernstoff20, Michael S Zens13 and Julia A Newton-Bishop1

1Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, Leeds, UK.
2School of Public Health, The University of Sydney, Sydney, Australia.
3Twin Research and Genetic Epidemiology Unit, St Thomas' Campus, Kings College London, London, UK.
4Dermatology Department, West Herts NHS Trust, Hemel Hempstead General Hospital, Herts, UK.
5Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.
6Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
7Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
8Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, BC, Canada.
9Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
10Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Brisbane, Australia.
11Department of Surgery, University Hospital, Lund, Sweden.
12Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.
13Department of Community and Family Medicine, Dartmouth Medical School and the Norris Cotton Cancer Center, Lebanon, NH, USA.
14Cancer Research Center of Hawaii, University of Hawaii, Honolulu, HI, USA.
15Department of Public Health and Health Policy, Faculty of Medicine, University of Glasgow, UK.
16Department of Oncology, University Hospital, Lund, Sweden.
17Kobenhaausevej 25, DK 3400 Hillerød, Denmark.
18Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine, London, UK.
19Section of Epidemiology, Institute of Cancer Research, Sir Richard Doll Building, Sutton, Surrey, UK.
20Department of Community and Family Medicine and Department of Pediatrics, Dartmouth Medical School and the Norris Cotton Cancer Center, Lebanon, NH, USA.

* Corresponding author. Cancer Genetics Building, St James's University Hospital, Beckett Street, Leeds LS9 7TF, UK. E-mail: y.chang{at}leeds.ac.uk


  Abstract

Background Melanoma risk is related to sun exposure; we have investigated risk variation by tumour site and latitude.

Methods We performed a pooled analysis of 15 case–control studies (5700 melanoma cases and 7216 controls), correlating patterns of sun exposure, sunburn and solar keratoses (three studies) with melanoma risk. Pooled odds ratios (pORs) and 95% Bayesian confidence intervals (CIs) were estimated using Bayesian unconditional polytomous logistic random-coefficients models.

Results Recreational sun exposure was a risk factor for melanoma on the trunk (pOR = 1.7; 95% CI: 1.4–2.2) and limbs (pOR = 1.4; 95% CI: 1.1–1.7), but not head and neck (pOR = 1.1; 95% CI: 0.8–1.4), across latitudes. Occupational sun exposure was associated with risk of melanoma on the head and neck at low latitudes (pOR = 1.7; 95% CI: 1.0–3.0). Total sun exposure was associated with increased risk of melanoma on the limbs at low latitudes (pOR = 1.5; 95% CI: 1.0–2.2), but not at other body sites or other latitudes. The pORs for sunburn in childhood were 1.5 (95% CI: 1.3–1.7), 1.5 (95% CI: 1.3–1.7) and 1.4 (95% CI: 1.1–1.7) for melanoma on the trunk, limbs, and head and neck, respectively, showing little variation across latitudes. The presence of head and neck solar keratoses was associated with increased risk of melanoma on the head and neck (pOR = 4.0; 95% CI: 1.7–9.1) and limbs (pOR = 4.0; 95% CI: 1.9–8.4).

Conclusion Melanoma risk at different body sites is associated with different amounts and patterns of sun exposure. Recreational sun exposure and sunburn are strong predictors of melanoma at all latitudes, whereas measures of occupational and total sun exposure appear to predict melanoma predominately at low latitudes.

Keywords Melanoma, recreational sun exposure, occupational sun exposure, total sun exposure, sunburn, solar keratoses

Accepted 25 February 2009


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.