Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis.
OBJECTIVE
Sunburns are an important risk factor for melanoma and those occurring in childhood are often cited as posing the greatest risk. We conducted a meta-analysis to quantify the magnitude of association for melanoma and sunburns during childhood, adolescence, adulthood and over a lifetime.


METHODS
After reviewing over 1300 article titles and evaluating 270 articles in detail, we pooled odds ratios from 51 independent study populations for "ever" sunburned and risk of cutaneous melanoma. Among these, 26 studies reported results from dose-response analyses. Dose-response analyses were examined using both fixed-effects models and Bayesian random-effects models.


RESULTS
An increased risk of melanoma was seen with increasing number of sunburns for all time-periods (childhood, adolescence, adulthood, and lifetime). In an attempt to understand how risk between life-periods compares, we also report these same linear models on a scale of five sunburns per decade for each life-period. The magnitude of risk for five sunburns per decade is highest for adult and lifetime sunburns.


CONCLUSIONS
Overall, these results show an increased risk of melanoma with increasing number of sunburns during all life-periods, not just childhood. Prevention efforts should focus on reducing sunburns during all life-periods.
Dennis
Leslie K
LK
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA. leslie-dennis@uiowa.edu
Vanbeek
Marta J
MJ
Beane Freeman
Laura E
LE
Smith
Brian J
BJ
Dawson
Deborah V
DV
Coughlin
Julie A
JA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D004307:Dose-Response Relationship, Radiation; D004781:Environmental Exposure / Q000009:adverse effects; D006801:Humans; D008545:Melanoma / Q000453:epidemiology*; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D016017:Odds Ratio; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D013471:Sunburn / Q000453:epidemiology*; D014466:Ultraviolet Rays / Q000009:adverse effects