Abstract
Objective
The aim of the study was to examine the relation between sun exposure and other selected risk factors and the development of different clinico-pathological variants of cutaneous malignant melanoma (CMM) at different body locations.
Methods:
We analysed data from a case-control study conducted in Italy between 1992 and 1994 on 542 cases of CMM and 538 hospital controls. Clinico-pathological variants included 391 superficial spreading (SSM), 72 nodular (NM) and 39 lentigo maligna (LMM) melanomas.
Results:
The risk of SSM increased for a high education level (odds ratio, OR = 1.5, 95% confidence interval, CI, 1.0–2.2), sunburn episodes before age 15 (OR = 1.8, 95% CI, 1.1–2.8), light eye colour (OR = 1.6, 95% CI, 1.1–2.4) and solar lentigines (OR = 1.4, 95% CI, 1.0–1.8). The ORs for total number of nevi >30 were 4.4 (95% CI, 2.9–6.7) for SSM, 5.7 (95% CI, 2.6–12.5) for NM and 2.2 (95% CI, 0.5–9.4) for LMM. The risk of CMM located on the trunk seemed to be higher for a high education level (OR = 1.6, 95% CI, 1.0–2.6) and propensity to sunburn (OR = 1.6, 95% CI, 0.8–3.2). The ORs for sunburn episodes, eye and skin colour, and solar lentigines tended to be higher for CMM located on the face/neck and on the upper limbs than the trunk. Total number of nevi was strongly associated with all anatomic locations.
Conclusions:
Total number of nevi was the major risk factor associated with all melanoma variants and locations. A higher level of education and sunburn episodes in early childhood appeared to be more strongly related to SSM than to other variants.
Similar content being viewed by others
References
DM Lipsker G Hedelin E Heid EM Grosshans BJ Cribier (1999) ArticleTitleStriking increase of thin melanomas contrasts with stable incidence of thick melanomas Arch Dermatol 135 1451–1456 Occurrence Handle10.1001/archderm.135.12.1451 Occurrence Handle10606049
RM MacKie CA Bray DJ Hole et al. (2002) ArticleTitleIncidence of and survival from malignant melanoma in Scotland: an epidemiological study Lancet 360 587–591 Occurrence Handle10.1016/S0140-6736(02)09779-9 Occurrence Handle12241928
E Crocetti P Carli (2004) ArticleTitleOnly superficial spreading melanoma is causing the melanoma epidemics? Eur J Epidemiol 19 91–92 Occurrence Handle10.1023/B:EJEP.0000013394.76682.b4 Occurrence Handle15012029
Levi F, Te VC, Randimbison L, La Vecchia C (2005) Trends in incidence of various morphologies of malignant melanoma in Vaud and Neuchatel, Switzerland. Melanoma Res 15: 73--75
A Osterlind G Engholm OM Jensen (1988) ArticleTitleTrends in cutaneous malignant melanoma in Denmark 1943–1982 by anatomic site APMIS 96 953–963 Occurrence Handle3196476
YT Chen T Zheng TR Holford M Berwick R Dubrow (1994) ArticleTitleMalignant melanoma incidence in Connecticut (United States): time trends and age-period-cohort modeling by anatomic site Cancer Causes Control 5 341–350 Occurrence Handle10.1007/BF01804985 Occurrence Handle8080946
S Franceschi F Levi L Randimbison C La Vecchia (1996) ArticleTitleSite distribution of different types of skin cancer: new aetiological clues Int J Cancer 67 24–28 Occurrence Handle10.1002/(SICI)1097-0215(19960703)67:1<24::AID-IJC6>3.0.CO;2-1 Occurrence Handle8690520
JL Bulliard B Cox (2000) ArticleTitleCutaneous malignant melanoma in New Zealand: trends by anatomical site, 1969–1993 Int J Epidemiol 29 416–423 Occurrence Handle10.1093/ije/29.3.416 Occurrence Handle10869312
F Levi VC Te L Randimbison G Erler C La Vecchia (2001) ArticleTitleTrends in skin cancer incidence in Vaud: an update, 1976–1998 Eur J Cancer Prev 10 371–373 Occurrence Handle10.1097/00008469-200108000-00011 Occurrence Handle11535880
F Levi G Erler VC Te L Randimbison C La Vecchia (2001) ArticleTitleTrends in skin cancer incidence in Neuchatel, 1976–98 Tumori 87 288–289 Occurrence Handle11765175
EA Holly DA Aston RD Cress DK Ahn JJ Kristiansen (1995) ArticleTitleCutaneous melanoma in women. II. Phenotypic characteristics and other host-related factors Am J Epidemiol 141 934–942 Occurrence Handle7741123
EA Holly DA Aston RD Cress DK Ahn JJ Kristiansen (1995) ArticleTitleCutaneous melanoma in women. I. Exposure to sunlight, ability to tan and other risk factors related to ultraviolet light Am J Epidemiol 141 923–933 Occurrence Handle7741122
CD Holman BK Armstrong (1984) ArticleTitleCutaneous malignant melanoma and indicators of total accumulated exposure to the sun: an analysis separating histogenetic types J Natl Cancer Inst 73 75–82 Occurrence Handle6588237
RP Gallagher JM Elwood GB Hill (1986) ArticleTitleRisk factors for cutaneous malignant melanoma: the Western Canada Melanoma Study Recent Results Cancer Res 102 38–55 Occurrence Handle3738186
LD Marrett WD King SD Walter L From (1992) ArticleTitleUse of host factors to identify people at high risk for cutaneous malignant melanoma CMAJ 147 445–453 Occurrence Handle1498755
B Langholz J Richardson E Rappaport J Waisman M Cockburn T Mack (2000) ArticleTitleSkin characteristics and risk of superficial spreading and nodular melanoma (United States) Cancer Causes Control 11 741–750 Occurrence Handle10.1023/A:1008952219416 Occurrence Handle11065011
JM Rodenas M Delgado-Rodriguez C Farinas-Alvarez MT Herranz S Serrano (1997) ArticleTitleMelanocytic nevi and risk of cutaneous malignant melanoma in southern Spain Am J Epidemiol 145 1020–1029 Occurrence Handle9169911
J Weiss J Bertz EG Jung (1991) ArticleTitleMalignant melanoma in southern Germany: different predictive value of risk factors for melanoma subtypes Dermatologica 183 109–113 Occurrence Handle1743370
A Masback J Westerdahl C Ingvar H Olsson N Jonsson (1999) ArticleTitleClinical and histopathological characteristics in relation to aetiological risk factors in cutaneous melanoma: a population-based study Melanoma Res 9 189–197 Occurrence Handle10380942
L Naldi IG Imberti F Parazzini S Gallus C La Vecchia (2000) ArticleTitlePigmentary traits, modalities of sun reaction, history of sunburns, and melanocytic nevi as risk factors for cutaneous malignant melanoma in the Italian population: results of a collaborative case-control study Cancer 88 2703–2710 Occurrence Handle10.1002/1097-0142(20000615)88:12<2703::AID-CNCR8>3.0.CO;2-Q Occurrence Handle10870052
NE Breslow NE Day (1980) Statistical Methods in Cancer Research, The Analysis of Case-Control Studies IARC Scientific Publication 32. IARC Lyon, France
DW Hosmer S Lemeshow (2001) Applied Logistic Regression EditionNumber2 John Wiley & Sons New York
PD Allison (1999) Logistic Regression Using the SAS System: Theory and Application SAS Institute Inc Cary, NC
F Faggiano T Partanen M Kogevinas P Boffetta (1997) ArticleTitleSocioeconomic differences in cancer incidence and mortality IARC Sci Publ 138 65–176 Occurrence Handle9353664
RA Harrison AU Haque JM Roseman SJ Soong (1998) ArticleTitleSocioeconomic characteristics and melanoma incidence Ann Epidemiol 8 327–333 Occurrence Handle10.1016/S1047-2797(97)00231-7 Occurrence Handle9669615
K Hemminki X Li (2003) ArticleTitleLevel of education and the risk of cancer in Sweden Cancer Epidemiol Biomarkers Prev 12 796–802 Occurrence Handle12917212
G Bentham A Aase (1996) ArticleTitleIncidence of malignant melanoma of the skin in Norway, 1955–1989: associations with solar ultraviolet radiation, income and holidays abroad Int J Epidemiol 25 1132–1138 Occurrence Handle9027516
IA Pion DS Rigel L Garfinkel MK Silverman AW Kopf (1995) ArticleTitleOccupation and the risk of malignant melanoma Cancer 75 637–644 Occurrence Handle7804988
E de Vries FI Bray JW Coebergh DM Parkin (2003) ArticleTitleChanging 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 107 119–126 Occurrence Handle10.1002/ijc.11360 Occurrence Handle12925966
RD Cress EA Holly DK Ahn PE LeBoit RW Sagebiel (1995) ArticleTitleCutaneous melanoma in women: anatomic distribution in relation to sun exposure and phenotype Cancer Epidemiol Biomarkers Prev 4 831–836 Occurrence Handle8634653
JM Bliss D Ford AJ Swerdlow BK Armstrong et al. (1995) ArticleTitleRisk of cutaneous melanoma associated with pigmentation characteristics and freckling: systematic overview of 10 case-control study Int J Cancer 62 367–376 Occurrence Handle7635560
J Lock-Andersen KT Drzewiecki HC Wulf (1999) ArticleTitleEye and hair colour, skin type and constitutive skin pigmentation as risk factors for basal cell carcinoma and cutaneous malignant melanoma. A Danish case-control study Acta Derm Venereol 79 74–80 Occurrence Handle10.1080/000155599750011778 Occurrence Handle10086866
JM Elwood SM Whitehead J Davison M Stewart M Galt (1990) ArticleTitleMalignant melanoma in England: risks associated with naevi, freckles, social class, hair colour, and sunburn Int J Epidemiol 19 801–810 Occurrence Handle2084006
Author information
Authors and Affiliations
Corresponding author
Additional information
* Address correspondence to: Andrea Altieri, Istituto di Ricerche Farmacologiche “Mario Negri”, Via Eritrea 62, 20157, Milan, Italy. Ph.: 4 Participants: F. Arcangeli, D. Calista, G. Landi (Cesena), A. Di Landro (Bergamo), P. Puiatti (Torino), C. Catricalà, L. Eibenschutz (Roma), G. Lo Scocco, V. Di Lernia (Reggio Emilia), A. Tosti, C.␣Misciali (Bologna), F. Scardigli, M. Cristofolini (Trento), M. Simonacci, M. Sigona (Macerata), G. Pasolini, A. Manganoni, A. Lonati (Brescia), R. Betti (Milano), A. Barba, F. De Agostini, C. Chieregato (Verona), G. Fabbrocini, N. Balato, P. Santoianni (Napoli), M.G. Bertazzoni, P. Danese (Mantova), I. Stanganelli (Ravenna), S. Moretti, P. Carli (Firenze), M. Iannantuono (S. Giovanni Rotondo), P. Taddeucci (Siena), A. Virgili (Ferrara), G. Fenizi (Foggia), E. Rossi, M. Pini, G. Galbiati (Monza), A. Locatelli (Como).
Rights and permissions
About this article
Cite this article
Naldi, L., Altieri, A., Imberti, G.L. et al. Sun Exposure, Phenotypic Characteristics, and Cutaneous Malignant Melanoma. An Analysis According to Different Clinico-Pathological Variants and Anatomic Locations (Italy). Cancer Causes Control 16, 893–899 (2005). https://doi.org/10.1007/s10552-005-2300-4
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10552-005-2300-4