Regular Article

British Journal of Cancer (2001) 85, 1304–1310. doi:10.1054/bjoc.2001.2029 www.bjcancer.com
Published online 30 October 2001

Combined risk factors for melanoma in a Mediterranean population

M T Landi1, A Baccarelli1,2, D Calista3, A Pesatori2, T Fears4, M A Tucker1 and G Landi3

  1. 1Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Bethesda, MD 20892-7236, USA
  2. 2EPOCA, Epidemiology Research Center, University of Milan, Via S. Barnaba 8, 20122 Milano, Italy
  3. 3Dermatology Unit, Bufalini Hospital, Viale Ghirotti 286, 47023 Cesena, Italy
  4. 4Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Bethesda, MD 20892-7236, USA

Received 2 May 2001; Revised 19 June 2001; Accepted 21 June 2001.

Top

Abstract

A case–control study of non-familial melanoma including 183 incident cases and 179 controls was conducted in North-Eastern Italy to identify important risk factors and determine how combination of these affects risk in a Mediterranean population. Presence of dysplastic nevi (OR = 4.2, 95% CI = 2.4–7.4), low propensity to tan (OR = 2.4, 95% CI = 1.1–5.0), light eye (OR = 2.4, 95% CI = 1.1–5.2), and light skin colour (OR = 4.1, 95% CI = 1.4–12.1) were significantly associated with melanoma risk after adjustment for age, gender and pigmentation characteristics. A chart which identifies melanoma risk associated with combinations of these factors is presented; it can be used to identify subjects who would most benefit from preventive measures in Mediterranean populations. According to the combination of these factors, a relative risk range from 1 to 98.5 was found. Light skin colour, high number of sunburns with blistering, and low propensity to tan were significantly associated with melanoma thickness, possibly indicating that individuals with these characteristics underestimate their risk and seek attention when their lesion is already advanced. © 2001 Cancer Research Campaign www.bjcancer.com

Keywords:

melanoma, dysplastic nevi, Mediterranean populations, pigmentation, melanoma thickness, risk factors

Top

References

  1. Bliss JM, Ford D, Swerdlow AJ, Armstrong BK, Cristofolini M, Elwood JM, Green A, Holly EA, Mack T and MacKie RM (1995) Risk of cutaneous melanoma associated with pigmentation characteristics and freckling: systematic overview of 10 case-control studies. The International Melanoma Analysis Group (IMAGE). Int J Cancer 62: 367–376 | PubMed | ISI | ChemPort |
  2. Calista D, Goldstein AM and Landi MT (2000) Melanoma familial aggregation in north-eastern italy. J Invest Dermatol 115: 764–765
  3. Carli P, Biggeri A and Giannotti B (1995) Malignant melanoma in Italy: risks associated with common and clinically atypical melanocytic nevi. J Am Acad Dermatol 32: 734–739
  4. Cristofolini M, Franceschi S, Tasin L, Zumiani G, Piscioli F, Talamini R and La Vecchia C (1987) Risk factors for cutaneous malignant melanoma in a northern Italian population. Int J Cancer 39: 150–154 | PubMed | ISI | ChemPort |
  5. Elwood JM and Gallagher RP (1999) More about: sunscreen use, wearing clothes, and number of nevi in 6- to 7-year-old European children. J Natl Cancer Inst 91: 1164–1166
  6. Espinosa Arranz J, Sanchez Hernandez JJ, Bravo Fernandez P, Gonzalez-Baron M, Zamora Aunon P, Espinosa Arranz E, Jalon Lopez JI and Ordonez Gallego A (1999) Cutaneous malignant melanoma and sun exposure in Spain. Melanoma Res 9: 199–205
  7. Ferlay J, Bray S, Pisani P and Parkin DM (2001) GLOBOCAN 2000: Cancer incidence, mortality and prevalence worldwide, Version 1.0. CancerBase No. 5. IARCPress: Lyon. Limited version available from: URL: http://www-dep.iarc.fr/globocan/globocan.htm/
  8. Garbe C, Buttner P, Weiss J, Soyer HP, Stocker U, Kruger S, Roser M, Weckbecker J, Panizzon R and Bahmer F (1994) Risk factors for developing cutaneous melanoma and criteria for identifying persons at risk: multicenter case-control study of the Central Malignant Melanoma Registry of the German Dermatological Society. J Invest Dermatol 102: 695–699 | Article | PubMed | ISI | ChemPort |
  9. Goldstein AM and Tucker MA (1995) Genetic epidemiology of familial melanoma. Dermatol Clin 13: 605–612 | PubMed | ISI | ChemPort |
  10. Greene MA and Fraumeni JF Jr (1979) The hereditary variant of malignant melanoma. InHuman malignant melanoma, Clark WHJr, Goldman LI, Mastrangelo LJ (eds) pp 139–166. Grune and Stratton: New York
  11. Hartge P, Holly EA, Halpern A, Sagebiel R, Guerry D, Elder D, Clark W, Hanson L, Harrison C and Tarone R (1995) Recognition and classification of clinically dysplastic nevi from photographs: a study of interobserver variation. Cancer Epidemiol Biomarkers Prev 4: 37–40
  12. Jemal A, Devesa SS, Fears TR and Hartge P (2000) Cancer surveillance series: changing patterns of cutaneous malignant melanoma mortality rates among whites in the United States. J Natl Cancer Inst 92: 811–818 | Article | PubMed | ChemPort |
  13. La Vecchia C (1999) Sunscreens and the risk of cutaneous malignant melanoma. Eur J Cancer Prev 8: 267–269
  14. Landi MT, Calista D, Landi G, Bernucci I, Bertazzi PA, Clark WHJ, Goldstein AM and Tucker MA (1999) Clinical characteristics of 20 Italian melanoma-prone families. Arch Dermatol 135: 1554–1555
  15. MacKie RM, Freudenberger T and Aitchison TC (1989) Personal risk-factor chart for cutaneous melanoma. Lancet 2: 487–490 | Article | PubMed | ISI | ChemPort |
  16. Muir CS, Waterhouse J, Mack T, Powell J and Whelan SL (1987) Cancer incidence in five continents. International Agency for Research on Cancer: Lyon
  17. Naldi L, Lorenzo IG, Parazzini F, Gallus S and La Vecchia C (2000a) Pigmentary 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 | Article | PubMed | ISI | ChemPort |
  18. Naldi L, Gallus S, Imberti GL, Cainelli T, Negri E and La Vecchia C (2000b) Sunscreens and cutaneous malignant melanoma: an Italian case-control study. Int J Cancer 86: 879–882
  19. Naldi L, Gallus S, Imberti GL, Cainelli T, Negri E and La Vecchia C (2000c) Sunlamps and sunbeds and the risk of cutaneous melanoma. Italian Group for Epidemiological Research in Dermatology. Eur J Cancer Prev 9: 133–134
  20. Parkin DM, Muir CS, Whelan SL, Gao YT, Ferlay J and Powell J (1992) Cancer incidence in five continents. International Agency for Research on Cancer: Lyon
  21. Rodenas JM, Delgado-Rodriguez M, Herranz MT, Tercedor J and Serrano S (1996) Sun exposure, pigmentary traits, and risk of cutaneous malignant melanoma: a case-control study in a Mediterranean population. Cancer Causes Control 7: 275–283
  22. Rosso S, Zanetti R, Pippione M and Sancho-Garnier H (1998) Parallel risk assessment of melanoma and basal cell carcinoma: skin characteristics and sun exposure. Melanoma Res 8: 573–583
  23. Scotto J, Fears TR and Fraumeni JFJr (1996) Solar radiation. InCancer epidemiology and prevention, Schottenfeld D, Fraumeni JF Jr. (eds) pp 355–372, Oxford University Press: New York
  24. Tucker MA, Halpern A, Holly EA, Hartge P, Elder DE, Sagebiel RW, Guerry D and Clark WHJ (1997) Clinically recognized dysplastic nevi. A central risk factor for cutaneous melanoma. JAMA 277: 1439–1444 | Article | PubMed | ISI | ChemPort |
  25. Vinceti M, Bergomi M, Borciani N, Serra L and Vivoli G (1999) Rising melanoma incidence in an Italian community from 1986 to 1997. Melanoma Res 9: 97–103 | Article | PubMed | ISI | ChemPort |
  26. Zanetti R, Rosso S, Colonna S, Martina G and Paudice A (1988) Studio caso-controllo sul melanoma maligno cutaneo in provincia di Torino [Case-control study on malignant skin melanoma in the Turin province]. G Ital Dermatol Venereol 123: 461–468
  27. Zanetti R, Gafa L, Franceschi S, Pippione M and Rosso S (1999) Estimate of the proportion of skin tumors attributable to sun exposure in 3 Italian populations. Epidemiol Prev 23: 416–422