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. 1984 Jan 14;288(6411):99–102. doi: 10.1136/bmj.288.6411.99

Pigmentation and skin reaction to sun as risk factors for cutaneous melanoma: Western Canada Melanoma Study.

J M Elwood, R P Gallagher, G B Hill, J J Spinelli, J C Pearson, W Threlfall
PMCID: PMC1443966  PMID: 6419839

Abstract

Between 1 April 1979 and 31 March 1981, 904 residents of the four western provinces of Canada (population 6.5 million), were diagnosed as suffering from primary cutaneous malignant melanoma. Of 801 patients aged 20-79 years, 665 (83%) were interviewed along with control subjects chosen at random from the general population and matched for age, sex, and province. After exclusion of 70 subjects with lentigo maligna or acral lentiginous melanoma, comparisons of the 595 case-control pairs showed that light hair, skin, and eye colour, a history of heavy freckling in adolescence, and a tendency to burn readily and tan poorly in the sun were significant risk factors for melanoma. The strongest primary associations were with blond hair (relative risk 7.1 compared with black hair), light colour of unexposed skin (relative risk 2.4), and severe freckling (relative risk 2.1). These associations were independent of ethnic origin and of recorded amount of exposure to the sun and were somewhat stronger for superficial spreading than for nodular melanoma. This study is the largest and most detailed of an incident series of melanomas to be published to date. The results were consistent with other studies reporting associations between melanoma and poor tanning ability, a tendency to burn easily, and a history of sunburn and showed that light hair colour was the strongest risk factor for the disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adam S. A., Sheaves J. K., Wright N. H., Mosser G., Harris R. W., Vessey M. P. A case-control study of the possible association between oral contraceptives and malignant melanoma. Br J Cancer. 1981 Jul;44(1):45–50. doi: 10.1038/bjc.1981.145. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Beitner H., Ringborg U., Wennersten G., Lagerlöf B. Further evidence for increased light sensitivity in patients with malignant melanoma. Br J Dermatol. 1981 Mar;104(3):289–294. doi: 10.1111/j.1365-2133.1981.tb00951.x. [DOI] [PubMed] [Google Scholar]
  3. Clark W. H., Jr, Mihm M. C., Jr Lentigo maligna and lentigo-maligna melanoma. Am J Pathol. 1969 Apr;55(1):39–67. [PMC free article] [PubMed] [Google Scholar]
  4. Crombie I. K. Racial differences in melanoma incidence. Br J Cancer. 1979 Aug;40(2):185–193. doi: 10.1038/bjc.1979.165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Crombie I. K. Variation of melanoma incidence with latitude in North America and Europe. Br J Cancer. 1979 Nov;40(5):774–781. doi: 10.1038/bjc.1979.260. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Elwood J. M., Lee J. A. Trends in mortality from primary tumours of skin in Canada. Can Med Assoc J. 1974 Apr 20;110(8):913–915. [PMC free article] [PubMed] [Google Scholar]
  7. Elwood J. M., Lee J. A., Walter S. D., Mo T., Green A. E. Relationship of melanoma and other skin cancer mortality to latitude and ultraviolet radiation in the United States and Canada. Int J Epidemiol. 1974 Dec;3(4):325–332. doi: 10.1093/ije/3.4.325. [DOI] [PubMed] [Google Scholar]
  8. Fears T. R., Scotto J., Schneiderman M. A. Skin cancer, melanoma, and sunlight. Am J Public Health. 1976 May;66(5):461–464. doi: 10.2105/ajph.66.5.461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gellin G. A., Kopf A. W., Garfinkel L. Malignant melanoma. A controlled study of possibly associated factors. Arch Dermatol. 1969 Jan;99(1):43–48. doi: 10.1001/archderm.99.1.43. [DOI] [PubMed] [Google Scholar]
  10. Holman C. D., James I. R., Gattey P. H., Armstrong B. K. An analysis of trends in mortality from malignant melanoma of the skin in Australia. Int J Cancer. 1980 Dec 15;26(6):703–709. doi: 10.1002/ijc.2910260602. [DOI] [PubMed] [Google Scholar]
  11. Jensen O. M., Bolander A. M. Trends in malignant melanoma of the skin. World Health Stat Q. 1980;33(1):2–26. [PubMed] [Google Scholar]
  12. Klepp O., Magnus K. Some environmental and bodily characteristics of melanoma patients. A case-control study. Int J Cancer. 1979 Apr 15;23(4):482–486. doi: 10.1002/ijc.2910230407. [DOI] [PubMed] [Google Scholar]
  13. LANCASTER H. O., NELSON J. Sunlight as a cause of melanoma; a clinical survey. Med J Aust. 1957 Apr 6;44(14):452–456. [PubMed] [Google Scholar]
  14. LANCASTER H. O. Some geographical aspects of the mortality from melanoma in Europeans. Med J Aust. 1956 Jun 30;43(26):1082–1087. [PubMed] [Google Scholar]
  15. Lee J. A., Carter A. P. Secular trends in mortality from malignant melanoma. J Natl Cancer Inst. 1970 Jul;45(1):91–97. [PubMed] [Google Scholar]
  16. MacKie R. M., Aitchison T. Severe sunburn and subsequent risk of primary cutaneous malignant melanoma in scotland. Br J Cancer. 1982 Dec;46(6):955–960. doi: 10.1038/bjc.1982.307. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. McGovern V. J., Shaw H. M., Milton G. W., Farago G. A. Is malignant melanoma arising in a Hutchinson's melanotic freckle a separate disease entity? Histopathology. 1980 May;4(3):235–242. doi: 10.1111/j.1365-2559.1980.tb02918.x. [DOI] [PubMed] [Google Scholar]
  18. Mishima Y. Melanocytic and nevocytic malignant melanomas. Cellular and subcellular differentiation. Cancer. 1967 May;20(5):632–649. doi: 10.1002/1097-0142(1967)20:5<632::aid-cncr2820200510>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  19. Moles and malignant melanoma: terminology and CLASSIFICATION. Med J Aust. 1967 Jan 21;1(3):123–125. doi: 10.5694/j.1326-5377.1967.tb21063.x. [DOI] [PubMed] [Google Scholar]
  20. Nicholls E. M. Genetic susceptibility and somatic mutation in the production of freckles, birthmarks and moles. Lancet. 1968 Jan 13;1(7533):71–73. doi: 10.1016/s0140-6736(68)90071-8. [DOI] [PubMed] [Google Scholar]
  21. PACK G. T., DAVIS J., OPPENHEIM A. The relation of race and complexion to the incidence of moles and melanomas. Ann N Y Acad Sci. 1963 Feb 15;100:719–742. [PubMed] [Google Scholar]
  22. Swerdlow A. J. Incidence of malignant melanoma of the skin in England and Wales and its relationship to sunshine. Br Med J. 1979 Nov 24;2(6201):1324–1327. doi: 10.1136/bmj.2.6201.1324. [DOI] [PMC free article] [PubMed] [Google Scholar]

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