title: Ethnicity and cutaneous melanoma in the city of Sao Paulo, Brazil: a case-control study.
abstract: BACKGROUND
  Over the last century the incidence of cutaneous melanoma has increased worldwide, a trend that has also been observed in Brazil. The identified risk factors for melanoma include the pattern of sun exposure, family history, and certain phenotypic features. In addition, the incidence of melanoma might be influenced by ethnicity. Like many countries, Brazil has high immigration rates and consequently a heterogeneous population. However, Brazil is unique among such countries in that the ethnic heterogeneity of its population is primarily attributable to admixture. This study aimed to evaluate the contribution of European ethnicity to the risk of cutaneous melanoma in Brazil.
  
  
  RESULTS
  We carried out a hospital-based case-control study in the metropolitan area of Sao Paulo, Brazil. We evaluated 424 hospitalized patients (202 melanoma patients and 222 control patients) regarding phenotypic features, sun exposure, and number of grandparents born in Europe. Through multivariate logistic regression analysis, we found the following variables to be independently associated with melanoma: grandparents born in Europe-Spain (OR = 3.01, 95% CI: 1.03-8.77), Italy (OR = 3.47, 95% CI: 1.41-8.57), a Germanic/Slavic country (OR = 3.06, 95% CI: 1.05-8.93), or ≥ 2 European countries (OR = 2.82, 95% CI: 1.06-7.47); eye color-light brown (OR = 1.99, 95% CI: 1.14-3.84) and green/blue (OR = 4.62; 95% CI 2.22-9.58); pigmented lesion removal (OR = 3.78; 95% CI: 2.21-6.49); no lifetime sunscreen use (OR = 3.08; 95% CI: 1.03-9.22); and lifetime severe sunburn (OR = 1.81; 95% CI: 1.03-3.19).
  
  
  CONCLUSIONS
  Our results indicate that European ancestry is a risk factor for cutaneous melanoma. Such risk appears to be related not only to skin type, eye color, and tanning capacity but also to others specific characteristics of European populations introduced in the New World by European immigrants.
authors.affiliation: Laboratório de Epidemiologia e Imunobiologia - LIM38, Departamento de Medicina Preventiva da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil. olinda@usp.br
authors.forename: Olinda C
authors.initials: OC
authors.lastname: Luiz
authors.forename: Reinaldo José
authors.initials: RJ
authors.lastname: Gianini
authors.forename: Fernanda T
authors.initials: FT
authors.lastname: Gonçalves
authors.forename: Guilherme
authors.initials: G
authors.lastname: Francisco
authors.forename: Cyro
authors.initials: C
authors.lastname: Festa-Neto
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Sanches
authors.forename: Gilka J F
authors.initials: GJ
authors.lastname: Gattas
authors.forename: Roger
authors.initials: R
authors.lastname: Chammas
authors.forename: José
authors.initials: J
authors.lastname: Eluf-Neto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000208:ethnology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000208:ethnology*; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012878:Skin Neoplasms / Q000208:ethnology*; D055815:Young Adult