Biologic markers of sun exposure and melanoma risk in women: pooled case-control analysis.
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 (p(trend) < 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.
Olsen
Catherine M
CM
Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia. Catherine.Olsen@qimr.edu.au
Zens
Michael S
MS
Green
Adele C
AC
Stukel
Therese A
TA
Holman
C D'Arcy J
CD
Mack
Thomas
T
Elwood
J Mark
JM
Holly
Elizabeth A
EA
Sacerdote
Carlotta
C
Gallagher
Richard
R
Swerdlow
Anthony J
AJ
Armstrong
Bruce K
BK
Rosso
Stefano
S
Kirkpatrick
Connie
C
Zanetti
Roberto
R
Bishop
Julia Newton
JN
Bataille
Veronique
V
Chang
Yu-Mei
YM
Mackie
Rona
R
Østerlind
Anne
A
Berwick
Marianne
M
Karagas
Margaret R
MR
Whiteman
David C
DC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007642:Keratosis / Q000453:epidemiology; D008545:Melanoma / Q000453:epidemiology*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000453:epidemiology*; D013471:Sunburn / Q000453:epidemiology; D013472:Sunlight
D015415:Biomarkers