Abstract
Aim
A melanoma case-control study was conducted to elucidate the complex relationship
between sun exposure and risk.
Methods
Nine hundred and sixty population-ascertained cases, 513 population and 174 sibling
controls recruited in England provided detailed sun exposure and phenotype data; a
subset provided serum 25-hydroxyvitamin D2 + D3 levels.
Results
Phenotypes associated with a tendency to sunburn and reported sunburn at ⩾20 years of age were associated with increased melanoma risk (odds ratio (OR) 1.56, 95%
confidence intervals (CI) 1.23–1.99). Holiday sun exposure was not associated with
an increased melanoma risk although this may be in part because reported sun exposure
overall was much lower in those with a sun-sensitive phenotype, particularly among
controls. Head and neck melanoma was associated with less sun exposure on holidays
at low latitudes (OR 0.39, 95% CI (0.23–0.68) for >13 h/year compared to <3.1). Overall the clearest relationship between reported sun exposure
and risk was for average weekend sun exposure in warmer months, which was protective
(OR 0.67, 95% CI 0.50–0.89 for highest versus lowest tertile of exposure). Serum vitamin
D levels were strongly associated with increased weekend and holiday sun exposure.
Conclusions
Sun-sensitive phenotypes and reported sunburn were associated with an increased risk
of melanoma. Although no evidence was seen of a causal relationship between holiday
sun exposure and increased risk, this is consistent with the view that intense sun
exposure is causal for melanoma in those prone to sunburn. A protective effect of
regular weekend sun exposure was seen, particularly for limb tumours, which could
be mediated by photoadaptation or higher vitamin D levels.
Abbreviations:
OR (odds ratio), CI (confidence intervals)Keywords
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Article info
Publication history
Published online: November 17, 2010
Accepted:
October 11,
2010
Received in revised form:
October 5,
2010
Received:
May 14,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
