A pooled analysis of melanocytic nevus phenotype and the risk of cutaneous melanoma at different latitudes.
An abnormal nevus phenotype is associated with an increased risk of melanoma. We report a pooled analysis conducted using individual nevus data from 15 case-control studies (5,421 melanoma cases and 6,966 controls). The aims were to quantify the risk better and to determine whether relative risk is varied by latitude. Bayesian unconditional logistic random coefficients models were employed to study the risk associated with nevus characteristics. Participants with whole body nevus counts in the highest of 4 population-based categories had a greatly increased risk of melanoma compared with those in the lowest category (pooled odds ratio (pOR) 6.9 (95% confidence interval (CI): 4.4, 11.2) for those aged<50 years and pOR 5.1 (95% CI: 3.6, 7.5) for those aged>or=50). The pOR for presence compared with absence of any clinically atypical nevi was 4.0 (95% CI: 2.8, 5.8). The pORs for 1-2 and >or=3 large nevi on the body compared with none were 2.9 (95% CI: 1.9, 4.3) and 7.1 (95% CI: 4.7, 11.6), respectively. The relative heterogeneities among studies were small for most measures of nevus phenotype, except for the analysis of nevus counts on the arms, which may have been due to methodological differences among studies. The pooled analysis also suggested that an abnormal nevus phenotype is associated most with melanomas on intermittently sun-exposed sites. The presence of increased numbers of nevi, large nevi and clinically atypical nevi on the body are robust risk factors for melanoma showing little variation in relative risk among studies performed at different latitudes.
Chang
Yu-mei
YM
Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, Leeds, United Kingdom. y.chang@leeds.ac.uk
Newton-Bishop
Julia A
JA
Bishop
D Timothy
DT
Armstrong
Bruce K
BK
Bataille
Veronique
V
Bergman
Wilma
W
Berwick
Marianne
M
Bracci
Paige M
PM
Elwood
J Mark
JM
Ernstoff
Marc S
MS
Green
Adèle C
AC
Gruis
Nelleke A
NA
Holly
Elizabeth A
EA
Ingvar
Christian
C
Kanetsky
Peter A
PA
Karagas
Margaret R
MR
Le Marchand
Loïc
L
Mackie
Rona M
RM
Olsson
Håkan
H
Østerlind
Anne
A
Rebbeck
Timothy R
TR
Reich
Kristian
K
Sasieni
Peter
P
Siskind
Victor
V
Swerdlow
Anthony J
AJ
Titus-Ernstoff
Linda
L
Zens
Michael S
MS
Ziegler
Andreas
A
Barrett
Jennifer H
JH
D000328:Adult; D001499:Bayes Theorem; D016022:Case-Control Studies; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D010641:Phenotype; D015203:Reproducibility of Results; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D013472:Sunlight
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