Risk Factors for Cutaneous Malignant Melanoma: The Western Canada Melanoma Study

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Over the past 3 decades the incidence and mortality from melanoma in Canada, the United Kingdom, United States, Australia and the Nordic countries has increased dramatically (Elwood and Lee 1974; Kopf et al. 1984; Little et al. 1980; Magnus 1977; Muir and Nectoux 1982). A number of factors have been linked aetiologically with melanoma, including host factors such as light skin, hair and eye colour (Elwood et al. 1984; Gellin et al. 1969; Holman and Armstrong 1984 a; Lancaster and Nelson 1957). There is evidence that risk of melanoma is related to sunlight exposure (Elwood and Hislop 1982; Holman et al. 1983), although the relationship is obviously not a simple one. It has been suggested that intermittent heavy sunlight exposure may be more important than constant dose in risk of superficial spreading melanomas, and this theory is supported by findings of similarity of incidence rates by unit area on usually and intermittently exposed body sites (Elwood and Gallagher 1983).