title: Cutaneous melanoma attributable to solar radiation in Cali, Colombia.
abstract: Estimating the population attributable fraction (PAF) of melanomas due to sun exposure is challenging as there are no unexposed population nor reliable exposure data. In high incidence countries, a historic cohort of the South Thames cancer registry was used as a minimally exposed population using the formula PAF = (observed incidence-incidence in minimally exposure)/observed incidence. In this study, we apply this method, constructing a minimally exposed cohort for Colombia and also using the historical South Thames data, using melanoma incidence data from the population-based cancer registry of Cali, Colombia for the period 1967-2012. The historic cohort incidence rates were very similar to those of Thames, but cohort effects were smaller for women and nonexistent for men. Age-specific incidence rates of these minimally exposed cohorts were applied to recent population numbers. For females, PAFs were 19% using the historic Thames cohort and 25% using the historic Cali cohort, corresponding numbers for males were 62% (vs. Thames) and 0% (vs. Cali). Taking into account the incidence rates of acral melanomas, which are not sun related, the PAF increased in women to 26% (vs. Thames) and 34% (vs. Cali) and for men 77% (vs. Thames). This exercise shows the modest contribution of exposure to ultraviolet radiation in the burden of melanoma in low-incidence countries, as well as the importance to take into consideration the acral lentiginous melanomas.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia.
authors.forename: Esther
authors.initials: E
authors.lastname: de Vries
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia.|Department of Dermatology, Hospital Militar Central de Colombia, Bogota, Colombia.
authors.forename: Julio R
authors.identifier: 0000-0002-2476-4991
authors.initials: JR
authors.lastname: Amador
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia.
authors.forename: Carlos Javier
authors.initials: CJ
authors.lastname: Rincon
authors.affiliation: Grupo de Estudio Genético de Enfermedades Complejas, Universidad Autónoma de Bucaramanga, Colombia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Uribe
authors.affiliation: Nuffield Department of Population Health, University of Oxford, United Kingdom.
authors.forename: Donald Maxwell
authors.initials: DM
authors.lastname: Parkin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003105:Colombia; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D012042:Registries; D012727:Sex Characteristics; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D013472:Sunlight / Q000009:adverse effects*; D014466:Ultraviolet Rays / Q000009:adverse effects*; D000096142:Cutaneous Malignant Melanoma
keywords: Colombia; melanoma; population attributable fraction; ultraviolet radiation