Ultraviolet Radiation and Malignant Melanoma

  • Johan Moan
  • Alina Carmen Porojnicu
  • Arne Dahlback
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 624)


Essential features of the epidemiology and photobiology of cutaneous malignant melanoma (CMM) in Norway were studied in comparison with data from countries at lower latitudes. Arguments for and against a relationship between ultraviolet radiation (UV) from sun and sun beds are discussed. Our data indicate that UV is a carcinogen for CMM and that intermittent exposures are notably melanomagenic. This hypothesis was supported both by latitude gradients, by time trends and by changing patterns of tumor density on different body localizations. However, even though UV radiation generates CMM, it may also have a protective action and/or an action that improves prognosis. The same may be true for a number of internal cancers.

There appears to be no, or even an inverse latitude gradient for CMM arising on non-UV exposed body localizations (uveal melanoma). Furthermore, CMM prognosis was gradually improved over all years of increasing incidence (up to 1990), but during the last 10 to 15 years, incidence rates decreased and prognosis was not further improved.

While CMM incidence rates are twice as high in South Norway as in North Norway, the ratios of death rates to incidence rates are higher in the North, where the annual UV fluences are lower. Death- and incidence rates in Australia and New Zealand fully support this.

Comparisons of skin cancer data from Norway and Australia/New Zealand indicate that squamous cell carcinoma and basal cell carcinoma are mainly related to annual solar UVB fluences, while UVA fluences play a larger role for CMM.


Skin Cancer Ultraviolet Radiation Basal Cell Carcinoma Cutaneous maUgnant Melanoma Uveal Melanoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Armstrong BK, Kricker A, English DR. Sun exposure and skin cancer. Australas J Dermatol 1997; 38Suppl 1:S1–S6.PubMedGoogle Scholar
  2. 2.
    Moan J, Dahlback A. Ultraviolet radiation and skin cancer: epidemiological data from Scandinavia. In: Young AR, Bjørn LO, Moan J, Nultsch W, eds. Environmental UV Photobiology. New York/London: Plenum Press; 1993:255–93.Google Scholar
  3. 3.
    Whiteman DC, Green AC. Melanoma and sun exposure: where are we now? Int J Dermatol 1999; 38:481–489.PubMedCrossRefGoogle Scholar
  4. 4.
    Elwood JM, Whitehead SM, Gallagher RP. Epidemiology of human malignant skin tumours with special reference to natural and artificial ultraviolet radiation exposure. In: Conti CJ, Slaga TJ, Klein-Szanto AJP, eds. Skin tumors: experimental and clinical aspects. New York: Raven Press; 1989:55–84.Google Scholar
  5. 5.
    Elwood JM. Melanoma and sun exposure: contrasts between intermittent and chronic exposure. World J Surg 1992; 16:157–165.PubMedCrossRefGoogle Scholar
  6. 6.
    Green A, Williams G. Ultraviolet radiation and skin cancer: epidemiological data from Australia. In: Young AR, Bjørn LO, Moan J, Nultsch W, eds. Environmental UV photobiology. New York/London: Plenum Press: 1993, 233–54.Google Scholar
  7. 7.
    Holman CD, Armstrong BK, Heenan PJ. Relationship of cutaneous malignant melanoma to individual sunlight-exposure habits. J Natl Cancer Inst 1986; 76:403–414.PubMedGoogle Scholar
  8. 8.
    Koh HK, Kligler BE, Lew RA. Sunlight and cutaneous malignant melanoma: evidence for and against causation. Photochem Photobiol 1990; 51:765–779.PubMedGoogle Scholar
  9. 9.
    Magnus K. Habits of sun exposure and risk of malignant melanoma: an analysis of incidence rates in Norway 1955–1977 by cohort, sex, age and primary tumor site. Cancer 1981; 48:2329–2335.PubMedCrossRefGoogle Scholar
  10. 10.
    Moan J, Dahlback A. Predictions of health consequences of a changing UV-fluence. In: Dubertret L, Santus R, Morliere P, eds. Ozone, sun, cancer. Paris: Les Editions Inserm, 1995:87–100.Google Scholar
  11. 11.
    Weinstock MA. Ultraviolet radiation and skin cancer: epidemiological data from the United States and Canada. In: Young AR, Bjørn LO, Moan J, Nultsch W, eds. Environmental UV photobiology. New York/London: Plenum Press, 1993:295–344.Google Scholar
  12. 12.
    Miller AJ, Mihm MC, Jr. Melanoma. N Engl J Med 2006; 355:51–65.PubMedCrossRefGoogle Scholar
  13. 13.
    AICR. Globocan 2002 database. Available online at (Accessed on February 2007).Google Scholar
  14. 14.
    Tangpricha V, Turner A, Spina C et al. Tanning is associated with optimal vitamin D status (serum 25-hydroxyvitamin D concentration) and higher bone mineral density. Am J Clin Nutr 2004; 80:1645–1649.PubMedGoogle Scholar
  15. 15.
    Matsuoka LY, Ide L, Wortsman J et al. Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrinol Metab 1987; 64:1165–1168.PubMedCrossRefGoogle Scholar
  16. 16.
    Christophers AJ. Melanoma is not caused by sunlight. Mutat Res 1998; 422:113–117.PubMedGoogle Scholar
  17. 17.
    Rampcn FH, Fleurcn E. Melanoma of the skin is not caused by ultraviolet radiation but by a chemical xenobiotic. Med Hypotheses 1987; 22:341–346.CrossRefGoogle Scholar
  18. 18.
    Rockley PF, Trieff N, Wagner RF et al. Nonsunlight risk factors for malignant melanoma. Part I: Chemical agents, physical conditions and occupation. Int J Dermatol 1994; 33:398–406.PubMedCrossRefGoogle Scholar
  19. 19.
    Beitner H, Ringborg U, Wennersten G et al. Further evidence for increased light sensitivity in patients with malignant melanoma. Br J Dermatol 1981; 104:289–294.PubMedCrossRefGoogle Scholar
  20. 20.
    Maestro R, Boiocchi M. Sunlight and melanoma: an answer from MTS1 (p16). Science 1995; 267:15–16.PubMedCrossRefGoogle Scholar
  21. 21.
    Dahlback A, Stamnes K. A new spherical model for computing the radiation field available for photolysis and heating rate at twilight. Planet Space Sci 1991; 671–683.Google Scholar
  22. 22.
    Stamnes K, Tsay SC, Wiscombe W et al. Numerically stable algorithm for discrete-ordinate-method for radiative transfer in multiple scattering and emitting layered media. Appl Opt 1988; 2502–2509.Google Scholar
  23. 23.
    McKinlay AF, Diffey AL. A reference action spectrum for ultraviolet induced erythema in human skin. CIE J 1987; 6:17–22.Google Scholar
  24. 24.
    Setlow RB, Grist E, Thompson K et al. Wavelengths effective in induction of malignant melanoma. Proc Natl Acad Sci USA 1993; 90:6666–6670.PubMedCrossRefGoogle Scholar
  25. 25.
    Porojnicu AC, Robsahm TE, Dahlback A et al. Seasonal and geographical variations in lung cancer prognosis in Norway. Does vitamin D from the sun play a role? Lung Cancer 2005 DOI: 10.1016/j lungcan 2006.11.013.Google Scholar
  26. 26.
    Moan J, Porojnicu AC, Dahlback A. Epidemiology of cutaneous malignant melanoma. In: Ringborg U, Brandberg Y, Breitbart EW, Greinert R, eds. Skin cancer prevention. New York: Informa Healthcare; 2006:179–201.Google Scholar
  27. 27.
    Moan J, Dahlback A, Setlow RB. Epidemiological support for an hypothesis for melanoma induction indicating a role for UVA radiation. Photochem Photobiol 1999; 70:243–247.PubMedCrossRefGoogle Scholar
  28. 28.
    Diffey B. Do we need a revised public health policy on sun exposure? Br J Dermatol 2006; 154:1046–1051.PubMedCrossRefGoogle Scholar
  29. 29.
    Berwick M, Armstrong BK, Ben Porat L et al. Sun exposure and mortality from melanoma. J Natl Cancer Inst 2005; 97:195–199.PubMedCrossRefGoogle Scholar
  30. 30.
    Sigmundsdottir H, Pan J, Debes GF et al. DCs metabolize sunlight-induced vitamin D3 to ‘program’ T cell attraction to the epidermal chemokine CCL27. Nat Immunol 2007. DOI: 10.1038/ni 1433.Google Scholar
  31. 31.
    Yu GP, Hu DN, McCormick SA. Latitude and Incidence of Ocular Melanoma. Photochem Photobiol 2006.Google Scholar
  32. 32.
    Lens MB, Dawes M. Global perspectives of contemporary epidemiological trends of cutaneous malignant melanoma. Br J Dermatol 2004; 150:179–185.PubMedCrossRefGoogle Scholar
  33. 33.
    Staples MP, Elwood M, Burton RC et al. Nonmelanoma skin cancer in Australia: the 2002 national survey and trends since 1985. Med J Aust 2006; 184:6–10.PubMedGoogle Scholar
  34. 34.
    Tucker MA, Goldstein AM. Melanoma etiology: where are we? Oncogene 2003; 22:3042–3052.PubMedCrossRefGoogle Scholar
  35. 35.
    Gandini S, Sera F, Cattaruzza MS et al. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer 2005; 41:45–60.PubMedCrossRefGoogle Scholar
  36. 36.
    Lee JA. Declining effect of latitude on melanoma mortality rates in the United States. A preliminary study. Am J Epidemiol 1997; 146:413–417.PubMedGoogle Scholar
  37. 37.
    Stang A, Parkin DM, Ferlay J et al. International uveal melanoma incidence trends in view of a decreasing proportion of morphological verification. Int J Cancer 2005; 114:114–123.PubMedCrossRefGoogle Scholar
  38. 38.
    Stang A, Schmidt-Pokrzywniak A, Lehnert M et al. Population-based incidence estimates of uveal melanoma in Germany. Supplementing cancer registry data by case-control data. Eur J Cancer Prev 2006; 15:165–170.PubMedCrossRefGoogle Scholar
  39. 39.
    Bergman L, Seregard S, Nilsson B et al. Incidence of uveal melanoma in Sweden from 1960 to 1998. Invest Ophthalmol Vis Sci 2002; 43:2579–2583.PubMedGoogle Scholar
  40. 40.
    de V E, Bray FI, Coebergh JW et al. Changing epidemiology of malignant cutaneous melanoma in Europe 1953–1997: rising trends in incidence and mortality but recent stabilizations in western Europe and decreases in Scandinavia. Int J Cancer 2003; 20;107:119–126.Google Scholar
  41. 41.
    De Vries E, Tyczynski JE, Parkin DM. Cutaneous malignant melanoma in Europe. ENCR Cancer fact sheets 4. 2003; France, European network of cancer registries.Google Scholar
  42. 42.
    Lund CC, Browder NC. The estimation of area of burns. Surg Gynecol Obstet 1944; 79:352–361.Google Scholar
  43. 43.
    Robsahm TE, Tretli S, Dahlback A et al. Vitamin D3 from sunlight may improve the prognosis of breast-, colon-and prostate cancer (Norway). Cancer Causes Control 2004; 15:149–158.PubMedCrossRefGoogle Scholar
  44. 44.
    Moan J, Porojnicu AC, Robsahm TE et al. Solar radiation, vitamin D and survival rate of colon cancer in Norway. J Photochem Photobiol B 2005; 78:189–193.PubMedCrossRefGoogle Scholar
  45. 45.
    Lim HS, Roychoudhuri R, Peto J et al. Cancer survival is dependent on season of diagnosis and sunlight exposure. Int J Cancer 2006; 119:1530–1536.PubMedCrossRefGoogle Scholar
  46. 46.
    Veierod MB, Weiderpass E, Thorn M et al. A prospective study of pigmentation, sun exposure and risk of cutaneous malignant melanoma in women. J Natl Cancer Inst 2003; 95:1530–1538.PubMedGoogle Scholar
  47. 47.
    Levine JA, Sorace M, Spencer J et al. The indoor UV tanning industry: a review of skin cancer risk, health benefit claims and regulation. J Am Acad Dermatol 2005; 53:1038–1044.PubMedCrossRefGoogle Scholar
  48. 48.
    Abdulla FR, Feldman SR, Wilhford PM et al. Tanning and skin cancer. Pediatr Dermatol 2005; 22:501–512.PubMedCrossRefGoogle Scholar
  49. 49.
    Ivry GB, Ogle CA, Shim EK. Role of sun exposure in melanoma. Dermatol Surg 2006; 32:481–492.PubMedCrossRefGoogle Scholar
  50. 50.
    The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. Int J Cancer 2007; 120:1116–1122.Google Scholar
  51. 51.
    Moan J, Lagunova Z, Porojnicu AC. Vitamin D, photobiology and relevance for cancer. Sunlight, Vitamin D and Health, 2006:33–40. Proceedings of the meeting Sunlight, Vitamin D and Health House of Commons London.Google Scholar
  52. 52.
    Pagh Nielsen K, Porojnicu AC, Lagunova Z et al. Solarier og sol produserer D-vitamin, mens solkremer med høy beskyttelsesfaktor reduserer produksjonen kraftig. Submitted, 2006.Google Scholar

Copyright information

© Landes Bioscience and Springer Science+Business Media 2008

Authors and Affiliations

  • Johan Moan
    • 1
    • 2
  • Alina Carmen Porojnicu
    • 1
  • Arne Dahlback
    • 2
  1. 1.Department of Radiation BiologyInstitute for Cancer ResearchMontebello
  2. 2.Department of PhysicsUniversity of OsloOsloNorway

Personalised recommendations