Biologic markers of sun exposure and melanoma risk in women: Pooled case–control analysis
Corresponding Author
Catherine M. Olsen
Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
C.M.O. and M.S.Z. have contributed equally to this work
Cancer and Population Studies group, Queensland Institute of Medical Research, Brisbane, AustraliaSearch for more papers by this authorMichael S. Zens
Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
C.M.O. and M.S.Z. have contributed equally to this work
Search for more papers by this authorAdele C. Green
Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
Search for more papers by this authorTherese A. Stukel
Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
Search for more papers by this authorC. D'Arcy J. Holman
School of Population Health, The University of Western Australia, Perth, WA, Australia
Search for more papers by this authorThomas Mack
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
Search for more papers by this authorJ. Mark Elwood
Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, BC, Canada
Search for more papers by this authorElizabeth A. Holly
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
Search for more papers by this authorCarlotta Sacerdote
Unit of Cancer Epidemiology, University of Turin, Torino, Italy
Search for more papers by this authorRichard Gallagher
Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, BC, Canada
Search for more papers by this authorAnthony J. Swerdlow
Institute of Cancer Research, Section of Epidemiology, Sutton, Surrey, United Kingdom
Search for more papers by this authorBruce K. Armstrong
Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorStefano Rosso
Piedmont Cancer Registry, CPO, Centre for Cancer Prevention, Torino, Italy
Search for more papers by this authorRoberto Zanetti
Piedmont Cancer Registry, CPO, Centre for Cancer Prevention, Torino, Italy
Search for more papers by this authorJulia Newton Bishop
Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, Leeds, United Kingdom
Search for more papers by this authorVeronique Bataille
Twin Research and Genetic Epidemiology Unit, St Thomas' Campus, Kings College London, United Kingdom
Dermatology Department, West Herts NHS Trust, Hemel Hempstead General Hospital, Herts, United Kingdom
Search for more papers by this authorYu-Mei Chang
Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, Leeds, United Kingdom
Search for more papers by this authorRona Mackie
Department of Public Health and Health Policy, University of Glasgow, Glasgow, United Kingdom
Search for more papers by this authorMarianne Berwick
Department of Internal Medicine, University of New Mexico, Albuquerque, NM
Search for more papers by this authorMargaret R. Karagas
Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
M.R.K. and D.C.W. are the senior authors of this work, have contributed equally to the manuscript.
Search for more papers by this authorDavid C. Whiteman
Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
M.R.K. and D.C.W. are the senior authors of this work, have contributed equally to the manuscript.
Search for more papers by this authorCorresponding Author
Catherine M. Olsen
Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
C.M.O. and M.S.Z. have contributed equally to this work
Cancer and Population Studies group, Queensland Institute of Medical Research, Brisbane, AustraliaSearch for more papers by this authorMichael S. Zens
Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
C.M.O. and M.S.Z. have contributed equally to this work
Search for more papers by this authorAdele C. Green
Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
Search for more papers by this authorTherese A. Stukel
Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
Search for more papers by this authorC. D'Arcy J. Holman
School of Population Health, The University of Western Australia, Perth, WA, Australia
Search for more papers by this authorThomas Mack
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
Search for more papers by this authorJ. Mark Elwood
Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, BC, Canada
Search for more papers by this authorElizabeth A. Holly
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
Search for more papers by this authorCarlotta Sacerdote
Unit of Cancer Epidemiology, University of Turin, Torino, Italy
Search for more papers by this authorRichard Gallagher
Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, BC, Canada
Search for more papers by this authorAnthony J. Swerdlow
Institute of Cancer Research, Section of Epidemiology, Sutton, Surrey, United Kingdom
Search for more papers by this authorBruce K. Armstrong
Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorStefano Rosso
Piedmont Cancer Registry, CPO, Centre for Cancer Prevention, Torino, Italy
Search for more papers by this authorRoberto Zanetti
Piedmont Cancer Registry, CPO, Centre for Cancer Prevention, Torino, Italy
Search for more papers by this authorJulia Newton Bishop
Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, Leeds, United Kingdom
Search for more papers by this authorVeronique Bataille
Twin Research and Genetic Epidemiology Unit, St Thomas' Campus, Kings College London, United Kingdom
Dermatology Department, West Herts NHS Trust, Hemel Hempstead General Hospital, Herts, United Kingdom
Search for more papers by this authorYu-Mei Chang
Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, Leeds, United Kingdom
Search for more papers by this authorRona Mackie
Department of Public Health and Health Policy, University of Glasgow, Glasgow, United Kingdom
Search for more papers by this authorMarianne Berwick
Department of Internal Medicine, University of New Mexico, Albuquerque, NM
Search for more papers by this authorMargaret R. Karagas
Section of Biostatistics and Epidemiology, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
M.R.K. and D.C.W. are the senior authors of this work, have contributed equally to the manuscript.
Search for more papers by this authorDavid C. Whiteman
Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
M.R.K. and D.C.W. are the senior authors of this work, have contributed equally to the manuscript.
Search for more papers by this authorAbstract
A model has been proposed whereby melanomas arise through two distinct pathways dependent on the relative influence of host susceptibility and sun exposure. Such pathways may explain site-specific patterns of melanoma occurrence. To explore this model, we investigated the relationship between melanoma risk and general markers of acute (recalled sunburns) and chronic (prevalent solar keratoses) sun exposure, stratified by anatomic site and host phenotype. Our working hypothesis was that head and neck melanomas have stronger associations with solar keratoses and weaker associations with sunburn than trunk melanomas. We conducted a collaborative analysis using original data from women subjects of 11 case–control studies of melanoma (2,575 cases, 3,241 controls). We adjusted for potential confounding effects of sunlamp use and sunbathing. The magnitude of sunburn associations did not differ significantly by melanoma site, nevus count or histologic subtype of melanoma. Across all sites, relative risk of melanoma increased with an increasing number of reported lifetime “painful” sunburns, lifetime “severe” sunburns and “severe” sunburns in youth (ptrend < 0.001), with pooled odds ratios (pORs) for the highest category of sunburns versus no sunburns of 3.22 [95% confidence interval (CI) 2.04–5.09] for lifetime “painful” sunburns, 2.10 (95%CI 1.30–3.38) for lifetime “severe” sunburns and 2.43 (95%CI 1.61–3.65) for “severe” sunburns in youth. Solar keratoses strongly increased the risk of head and neck melanoma (pOR 4.91, 95%CI 2.10–11.46), but data were insufficient to assess risk for other sites. Reported sunburn is strongly associated with melanoma on all major body sites.
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