title: Risk associations of melanoma in a Southern European population: results of a case/control study.
abstract: OBJECTIVE
  Limited data exist about the risk factors of melanoma in the Greek population. We investigated the association of melanoma with phenotypic and solar indices in this darker skin population residing in an environment of high ambient ultraviolet radiation.
  
  
  METHODS
  Our study included 200 sporadic melanoma cases and 200 age-, sex-matched control subjects. Information on history of sun exposure patterns and cutaneous reaction to sunlight was obtained and a clinical evaluation of pigmentary traits, pigmented lesions, and actinic keratoses was performed.
  
  
  RESULTS
  In the multivariate analysis, fair skin (OR: 4.63, for fair skin versus light brown, 95% CI: 1.54-13.92), intermittent sun exposure during childhood (OR: 3.33, >2 weeks/year of sun exposure versus < or =2 weeks/year 95% CI: 1.37-8.09), and outdoor leisure activities (OR: 2.74, 95% CI: 1.28-5.89), but not skin phototype or sunburns, were positively related to the risk of melanoma. In addition to an elevated count of common melanocytic nevi (OR: 6.27, > or =10 nevi versus no nevi, 95% CI: 1.65-23.76) and the presence of clinically atypical nevi (OR: 2.84, 95% CI: 1.16-6.98), solar lentigenes were an independent risk factor of melanoma (OR: 4.33, 95% CI: 1.67-11.22).
  
  
  CONCLUSIONS
  Intermittent sun exposure of moderate intensity during childhood/adolescence and outdoor leisural activities, in conjunction with a more resistant skin phenotype to acute sunburns and a strong association with nevi and solar lentigenes was a prominent determinant of melanoma risk in our population.
authors.affiliation: Department of Dermatology, University of Athens, Andreas Sygros Hospital, 5 Dragoumi Street, Athens, 10671, Greece.
authors.forename: Vasiliki A
authors.initials: VA
authors.lastname: Nikolaou
authors.forename: Vana
authors.initials: V
authors.lastname: Sypsa
authors.forename: Irene
authors.initials: I
authors.lastname: Stefanaki
authors.forename: Helen
authors.initials: H
authors.lastname: Gogas
authors.forename: Othon
authors.initials: O
authors.lastname: Papadopoulos
authors.forename: Dorothea
authors.initials: D
authors.lastname: Polydorou
authors.forename: Michaela
authors.initials: M
authors.lastname: Plaka
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Tsoutsos
authors.forename: Anastasia
authors.initials: A
authors.lastname: Dimou
authors.forename: Eleni
authors.initials: E
authors.lastname: Mourtzoukou
authors.forename: Valantis
authors.initials: V
authors.lastname: Korfitis
authors.forename: Eftihia
authors.initials: E
authors.lastname: Hatziolou
authors.forename: Christina
authors.initials: C
authors.lastname: Antoniou
authors.forename: Angelos
authors.initials: A
authors.lastname: Hatzakis
authors.forename: Andreas
authors.initials: A
authors.lastname: Katsambas
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Stratigos
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D009506:Nevus / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D012880:Skin Pigmentation; D013471:Sunburn / Q000453:epidemiology; D013472:Sunlight / Q000009:adverse effects*; D011795:Surveys and Questionnaires