title: Clustering of cutaneous melanoma in health care workers of a dermatological day hospital unit.
abstract: BACKGROUND
  The incidence of cutaneous melanoma is increasing but in most countries is still below 20/100,000 per year. Despite such a low frequency of occurrence, recently the authors have had notice of several new melanoma cases among colleagues. We carried out a survey of melanoma occurrence among the personnel, and their close relatives, of a dermatological clinic. The self-reported figures were compared with data from cancer registries.
  
  
  METHODS
  Thirty-eight doctors and nurses were surveyed. Three responders reported having had a diagnosis of melanoma (7.9%, 95% CI 1.7-21.4%). The respondents reported having 617 'relatives who are alive today and would have come to them if they had a melanoma': 12 had known diagnoses of melanoma (1.9%, 95% CI 1.0-3.4%). The relative risks were 26.3 (95% CI 8.9-78.0) and 4.1 (95% CI 1.2-13.8) for doctors and nurses compared to the general population and to their relatives, respectively, and 6.5 (95% CI 3.7-11.4) for relatives compared to the general population.
  
  
  CONCLUSIONS
  Two nonmutually exclusive hypotheses may be formulated to explain these findings: (a) most cutaneous melanomas regress spontaneously; (b) an infectious agent is involved in the causal pathway of cutaneous melanoma. Further studies may be warranted to confirm our observations and test such hypotheses.
authors.affiliation: Health Services Research Unit, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Paradisi
authors.forename: Damiano
authors.initials: D
authors.lastname: Abeni
mesh_terms: D000328:Adult; D017677:Age Distribution; D000554:Ambulatory Care Facilities; D016000:Cluster Analysis; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006782:Hospitals, Special; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D009726:Nurses / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D018570:Risk Assessment; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D000096142:Cutaneous Malignant Melanoma