title: Biologic markers of sun exposure and melanoma risk in women: pooled case-control analysis.
abstract: 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.
authors.affiliation: Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia. Catherine.Olsen@qimr.edu.au
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Olsen
authors.forename: Michael S
authors.initials: MS
authors.lastname: Zens
authors.forename: Adele C
authors.initials: AC
authors.lastname: Green
authors.forename: Therese A
authors.initials: TA
authors.lastname: Stukel
authors.forename: C D'Arcy J
authors.initials: CD
authors.lastname: Holman
authors.forename: Thomas
authors.initials: T
authors.lastname: Mack
authors.forename: J Mark
authors.initials: JM
authors.lastname: Elwood
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Holly
authors.forename: Carlotta
authors.initials: C
authors.lastname: Sacerdote
authors.forename: Richard
authors.initials: R
authors.lastname: Gallagher
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Swerdlow
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Armstrong
authors.forename: Stefano
authors.initials: S
authors.lastname: Rosso
authors.forename: Connie
authors.initials: C
authors.lastname: Kirkpatrick
authors.forename: Roberto
authors.initials: R
authors.lastname: Zanetti
authors.forename: Julia Newton
authors.initials: JN
authors.lastname: Bishop
authors.forename: Veronique
authors.initials: V
authors.lastname: Bataille
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Chang
authors.forename: Rona
authors.initials: R
authors.lastname: Mackie
authors.forename: Anne
authors.initials: A
authors.lastname: Østerlind
authors.forename: Marianne
authors.initials: M
authors.lastname: Berwick
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Karagas
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
mesh_terms: 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
chemical_list: D015415:Biomarkers