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JNCI Journal of the National Cancer Institute 2003 95(20):1530-1538; doi:10.1093/jnci/djg075
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© 2003 Oxford University Press

ARTICLE

A Prospective Study of Pigmentation, Sun Exposure, and Risk of Cutaneous Malignant Melanoma in Women

Marit Bragelien Veierød, Elisabete Weiderpass, Magnus Thörn, Johan Hansson, Eiliv Lund, Bruce Armstrong, Hans-Olov Adami

Affiliations of authors: M. B. Veierød, Section of Medical Statistics, University of Oslo, Oslo, Norway; E. Weiderpass, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, and International Agency for Research on Cancer, Lyon, France; M. Thörn, Department of Surgery, South Stockholm General Hospital, Stockholm; J. Hansson, Department of Oncology and Pathology, Karolinska Institutet; E. Lund, Institute of Community Medicine, University of Tromsø, Tromsø, Norway; B. Armstrong, School of Public Health, University of Sydney, Sydney, Australia; H.-O. Adami, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and Department of Epidemiology, Harvard University, Boston, MA.

Correspondence to: Marit B. Veierød, PhD, Section of Medical Statistics, University of Oslo, P.O. Box 1122 Blindern, N-0317 Oslo, Norway (e-mail: marit.veierod{at}basalmed.uio.no).

Background: Although sun exposure is an established cause of cutaneous malignant melanoma, possible interactions with host factors remain incompletely understood. Here we report the first results from a large prospective cohort study of pigmentation factors and sun exposure in relation to melanoma risk. Methods: The Women’s Lifestyle and Health Cohort Study included 106 379 women from Norway and Sweden who were aged 30–50 years in 1991 or 1992 when they completed an extensive questionnaire on personal characteristics and exposures. Linkages to national registries ensured complete follow-up through December 31, 1999. Poisson regression models were used to estimate relative risks (RRs). All statistical tests were two-sided. Results: During an average follow-up of 8.1 years, 187 cases of melanoma were diagnosed. Risk of melanoma was statistically significantly associated with increasing body surface area (RR for >=1.79 m2 versus <=1.61 m2 = 1.60, 95% confidence interval [CI] = 1.03 to 2.48; Ptrend = .02), number of large asymmetric nevi on the legs (RR for >=7 nevi versus 0 nevi = 5.29, 95% CI = 2.33 to 12.01; Ptrend<.001), hair color (RR for red versus dark brown or black = 4.05, 95% CI = 2.11 to 7.76; Ptrend<.001), sunburns per year at ages 10–19, 20–29, and 30–39 years (Ptrend<.001, Ptrend = .03, and Ptrend = .05, respectively), and use of a device that emits artificial light (solarium) one or more times per month (P = .04). Conclusions: Our results confirm previous findings that hair color, number of nevi on the legs, and history of sunburn are risk factors for melanoma and suggest that use of a solarium is also associated with melanoma risk. Adolescence and early adulthood appear to be among the most sensitive age periods for the effects of sunburn and solarium use on melanoma risk. However, it may be too early to see the full effect of adult exposures in this cohort.



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Correspondence about this Article

Re: A Prospective Study of Pigmentation, Sun Exposure, and Risk of Cutaneous Malignant Melanoma in Women
DeAnn Lazovich, Carol Sweeney, Martin A. Weinstock, and Marianne Berwick
J Natl Cancer Inst 2004 96: 335. [Extract] [Full Text] [PDF]

Re: A Prospective Study of Pigmentation, Sun Exposure, and Risk of Cutaneous Malignant Melanoma in Women
Mathieu Boniol, Philippe Autier, and Jean-François Doré
J Natl Cancer Inst 2004 96: 335-336. [Extract] [Full Text] [PDF]

RESPONSE: Re: A Prospective Study of Pigmentation, Sun Exposure, and Risk of Cutaneous Malignant Melanoma in Women
David C. Whiteman and Adèle C. Green
J Natl Cancer Inst 2004 96: 336-337. [Extract] [Full Text] [PDF]

RESPONSE: Re: A Prospective Study of Pigmentation, Sun Exposure, and Risk of Cutaneous Malignant Melanoma in Women
Marit Bragelien Veierød, Elisabete Weiderpass, Eiliv Lund, Bruce Armstrong, and Hans-Olov Adami
J Natl Cancer Inst 2004 96: 337-338. [Extract] [Full Text] [PDF]



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