© 2005 Oxford University Press
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Sun Exposure and Mortality From Melanoma
Affiliations of authors: University of New Mexico, Albuquerque, NM (MB); University of Sydney, Sydney, Australia (BKA, AK); Memorial Sloan-Kettering Cancer Center, New York, NY (LBP); University of Connecticut Health Center, Farmington, CT (JF); Albert Einstein College of Medicine, New York, NY (CE); University of Miami, Miami, FL (RB)
Correspondence to: Marianne Berwick, PhD, MPH, University of New Mexico, Department of Internal Medicine, New Mexico Cancer Research Facility, MSC08 4630, Room 103A, 1 University of New Mexico, Albuquerque, NM 87131 (e-mail: mberwick{at}salud.unm.edu).
Background: Melanoma incidence and survival are positively associated, both geographically and temporally. Solar elastosis, a histologic indicator of cutaneous sun damage, has also been positively associated with melanoma survival. Although these observations raise the possibility that sun exposure increases melanoma survival, they could be explained by an association between incidence and early detection of melanoma. We therefore evaluated the association between measures of skin screening and death from cutaneous melanoma. Methods: Case subjects (n = 528) from a population-based study of cutaneous melanoma were followed for an average of more than 5 years. Data, including measures of intermittent sun exposure, perceived awareness of the skin, skin self-screening, and physician screening, were collected during in-person interviews and review of histopathology and histologic parameters (i.e., solar elastosis, Breslow thickness, and mitoses) for all of the lesions. Competing risk models were used to compute risk of death (hazard ratios [HRs], with 95% confidence intervals [CIs]) from melanoma. All statistical tests were two-sided. Results: Sunburn, high intermittent sun exposure, skin awareness histories, and solar elastosis were statistically significantly inversely associated with death from melanoma. Melanoma thickness, mitoses, ulceration, and anatomic location on the head and neck were statistically significantly positively associated with melanoma death. In a multivariable competing risk analysis, skin awareness (with versus without, HR = 0.5, 95% CI = 0.3 to 0.9, P = .022) and solar elastosis (present versus absent, HR = 0.4, 95% CI = 0.2 to 0.8, P = .009) were strongly and independently associated with melanoma death after adjusting for Breslow thickness, mitotic index, and head and neck location, which were also independently associated with death. Conclusions: Sun exposure is associated with increased survival from melanoma.
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Correspondence about this Article
- Re: Sun Exposure and Mortality From Melanoma
- Richard S. Kalish
J Natl Cancer Inst 2005 97: 1158.[Extract] [Full Text] [PDF]
- Re: Sun Exposure and Mortality From Melanoma
- Robert D. Dellavalle and Kathryn R. Johnson
J Natl Cancer Inst 2005 97: 1158-1159.[Extract] [Full Text] [PDF]
- Re: Sun Exposure and Mortality From Melanoma
- Philippe Autier, Gianluca Severi, Mathieu Boniol, Esther de Vries, Jan-Willem Coebergh, and Jean-François Doré
J Natl Cancer Inst 2005 97: 1159.[Extract] [Full Text] [PDF]
- Re: Sun Exposure and Mortality From Melanoma
- Thomas R. Fears and Margaret A. Tucker
J Natl Cancer Inst 2005 97: 1789-1790.[Extract] [Full Text] [PDF]
Editorial about this Article
- Sunlight and Reduced Risk of Cancer: Is The Real Story Vitamin D?
- Kathleen M. Egan, Jeffrey A. Sosman, and William J. Blot
J Natl Cancer Inst 2005 97: 161-163.[Extract] [Full Text] [PDF]
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- Press Release: Two Studies Find Evidence That Sunlight May Have Beneficial Influence on Cancer
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