Skip to main content
Log in

Sun exposure, pigmentary traits, and risk of cutaneous malignant melanoma: a case-control study in a Mediterranean population

  • Review Papers
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

The main objective of this study was to assess the influence of sun exposure and pigmentary traits on the risk of cutaneous malignant melanoma (CMM) in a Mediterranean population (Andalusia, southern Spain). Cases and controls were selected from 1988 to 1993. The study population included 105 incident cases with non-familial CMM (ICD-9 code 172) and 138 controls aged 20 to 79 years. Data were collected by personal interview, and melanocytic nevi were counted over the entire body surface. Crude, and multiple-risk factor adjusted, odds ratios (OR) and their 95 percent confidence intervals (CI) were computed. After adjustment, the major constitutional risk factor was skin type I-II (OR=29.8, CI=8.9–100) compared with skin type V. Statistically significant and positive trends were observed between the risk of CMM and occupational sun exposure of the skin (P=0.003), recreational exposure (P<0.001), and cumulative lifetime sun exposure (P<0.001). Several characteristics related to sun exposure during summer increased the CMM risk, e.g., episodes of blistering sunburns and the number of sunbaths in childhood. Use of sunsreens and spending summer holidays in places other than beach were associated with a lower risk of CMM. Regarding pigmentary traits, CMM significantly occurred with more frequency in individuals with a high degree of freckling and quoted numbers of melanocytic nevi. In conclusion, the results support sun exposure and pigmentary traits (skin type, melanocytic nevi, and freckles) as main risk factors for CMM in this population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Parkin DM, Muir CS, Whelan SL, Gao IT, Ferlay J. Cancer Incidence in Five Continents, Vol. VI. Lyon, France: International Agency for Research on Cancer, 1992, IARC Sci. Pub. No. 120.

    Google Scholar 

  2. Waterhouse J, Muir C, Shanmugaratnam K, Powell J. Cancer Incidence in Five Continents Vol. IV. Lyon, France: International Agency for Research on Cancer, 1982; IARC Sci. Publ. No. 42.

    Google Scholar 

  3. Armstrong BK, English DR. Epidemiologic studies. In: Balch CM, Houghton AN, Milton GW, Sober AJ, Soong SI, eds. Cutaneous Melanoma. Philadelphia, PA (USA): Lippincott, 1992: 12–26.

    Google Scholar 

  4. Zanetti R, Franceschi S, Rosso S, Colonna S, Bidoli E. Cutaneous melanoma and sunburns in childhood in a Southern European population. Eur J Cancer 1992; 28A: 1172–6.

    Google Scholar 

  5. Autier P, Doré J-F, Lejeune F, et al. Recreational exposure to sunlight and lack of information as risk factors for cutaneous malignant melanoma. Results of an European Organization for Research and Treatment of Cancer (EORTC) case-control study in Belgium, France and Germany. Melanoma Res 1994; 4: 79–85.

    Google Scholar 

  6. Elwood JM, Gallagher RP, Hill GP, Pearson JCG. Cutaneous melanoma in relation to intermittent and constant sun exposure—The Western Canada Melanoma Study. Int J Cancer 1985; 35: 427–33.

    Google Scholar 

  7. Holman CDJ, Armstrong BK, Heenan PJ. Relationship of cutaneous malignant melanoma to individual sunlight-exposure habits. JNCI 1986; 76: 403–14.

    Google Scholar 

  8. Cristofolini M, Franceschi S, Tasin L, et al. Risk factors for cutaneous malignant melanoma in a northern Italian population. Int J Cancer 1987; 39: 150–4.

    Google Scholar 

  9. Osterlind A, Tucker MA, Hou-Jensen K, Stone BJ, Engholm G, Jensen OM. The Danish case-control study of cutaneous malignant melanoma. I. Importance of host factors. Int J Cancer 1988; 42: 200–6.

    Google Scholar 

  10. Osterlind A, Tucker MA, Stone BJ, Jensen OM. The Danish case-control study of cutaneous malignant melanoma. II. Importance of UV-light exposure. Int J Cancer 1988; 42: 319–24.

    Google Scholar 

  11. MacKie RM, Freudenberger T, Aitchison TC. Personal risk-factor chart for cutaneous melanoma. Lancet 1989; 2: 487–90.

    Google Scholar 

  12. Beitner H, Norell SE, Ringborg U, Wennersten G, Mattson B. Malignant melanoma: aetiological importance of individual pigmentation and sun exposure. Br J Dermatol 1990; 122: 43–51.

    Google Scholar 

  13. Elwood JM, Whitehead SM, Davison J, Stewart M, Galt M. Malignant melanoma in England: risk associated with naevi, freckles, social class, hair colour and sunburn. Int J Epidemiol 1990; 19: 801–10.

    Google Scholar 

  14. Augustsson A. Melanocytic naevi, melanoma and sun exposure. Acta Dermatol Venereol (Stockh) 1991; 166 (suppl): 1–34.

    Google Scholar 

  15. World Health Organization. International Classification of Diseases, Ninth Revision. Geneva, Switzerland: WHO: 1977.

    Google Scholar 

  16. Fitzpatrick TB. The validity and practicability of sun-reactive skin types I through VI. Arch Dermatol 1988; 124: 869–71.

    Google Scholar 

  17. Gallagher RP, Mclean DI, Yang P, et al. Suntan, sunburn, and pigmentation factors and the frequency of acquired melanocytic nevi in children. Similarities to melanoma: the Vancouver Mole Study. Arch Dermatol 1990; 126: 770–6.

    Google Scholar 

  18. Kelly JW, Crutcher WA, Sagebiel RW. Clinical diagnosis of dysplastic melanocytic nevi. A clinicopathological correlation. J Am Acad Dermatol 1986; 14: 1044–52.

    Google Scholar 

  19. Dean AG, Dean JA, Burton AH, Dicker RC, Epi Info, Version 5: A Word Processing, Database, and Statistics Program for Epidemiology on Microcomputers. Atlanta, GA (USA): Centers for Disease Control, 1990.

    Google Scholar 

  20. Lee J. An insight on the use of multiple logistic regression analysis to estimate association between risk factors and disease occurrence. Int J Epidemiol 1986; 15: 22–9.

    Google Scholar 

  21. Thompson WD. Statistical analysis of case-control studies. Epidemiol Rev 1994; 16: 33–50.

    Google Scholar 

  22. Dixon WJ. BMDP Statistical Software Manual. Berkeley, CA (USA): University of California Press, 1990.

    Google Scholar 

  23. Elwood JM, Gallagher RP, Hill GP, Spinelli JJ, Pearson JCG, Threlfall W. Pigmentation and skin reaction to sun as risk factors for cutaneous melanoma: Western Canada Melanoma Study. Br Med J 1984; 288: 99–102.

    Google Scholar 

  24. Holman CD, Armstrong BK. Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. JNCI 1984; 72: 257–66.

    Google Scholar 

  25. Grob JJ, Gouvernet J, Aymar D, et al. Count of benign melanocytic nevi as a major indicator of risk for nonfamilial nodular and superficial spreading melanoma. Cancer 1990; 66: 387–95.

    Google Scholar 

  26. Armstrong BK. Epidemiology of malignant melanoma: intermittent or total accumulated exposure to the sun. J Dermatol Surg Oncol 1988; 14: 835–49.

    Google Scholar 

  27. Zanetti R, Rosso S, Faggiano F, Roffino R, Colonna S, Martina G. Etude case-témoins sur le mélanome de la peau dans la province de Torino, Italie. Rev Epidém Santé Publ 1988; 36: 309–17.

    Google Scholar 

  28. Whiteman D, Green A. Melanoma and sunburn. Cancer Causes Control 1994; 5: 564–72.

    Google Scholar 

  29. V»gerö D. Ringbäck G, Kirivanta H. Melanoma and other tumours of the skin among office, other indoor and outdoor workers in Sweden 1961–1979. Br J Cancer 1986; 53: 507–12.

    Google Scholar 

  30. Garbe C, Krügers S, Stadler R, Guggenmoos-Holzmann I, Orfanos CE. Markers and relative risk in a German Population for developing malignant melanoma. Int J Dermatol 1989; 28: 517–23.

    Google Scholar 

  31. Skolnick AA. Sunscreen protection controversy heats up. JAMA 1991; 265: 3218–20.

    Google Scholar 

  32. Holman CD, Armstrong BK. Cutaneous malignant melanoma and indicators of total accumulated exposure to the sun: an analysis separating histogenetic types. JNCI 1984; 73: 75–82.

    Google Scholar 

  33. Gallagher RP, Elwood JM, Yang CP. Is chronic sunlight exposure important in accounting for increases in melanoma incidence? Int J Cancer 1989; 44: 813–5.

    Google Scholar 

  34. Dubin N, Moseson M, Pasternack BS. Epidemiology of malignant melanoma: pigmentary traits, ultraviolet radiation, and the identification of high-risk populations. Recent Results Cancer Res 1986; 102: 56–75.

    Google Scholar 

Download references

Authors

Additional information

Drs Rôdenas, Tercedor and Serrano are with the Department of Dermatology, School of Medicine, University of Granada, Granada,Spain. Authors are also affiliated with the Division of Epidemiology and Preventive Medicine, University of Cantabria, Santander, Spain (Dr Delgado-Rodríguez); the Service of Dermatology, Hospital Virgen de las Nieves, Granada, Spain (Dr Tercedor); and the Service of Internal Medicine, Hospital General Universitario Morales Meseguer, Murcia, Spain (Dr Herranz) Dr Ródenas, at present, is affiliated with the Department of Dermatology, Hospital General Universitario Morales Meseguer, Murcia, Spain. Address correspondence to Dr Ródenas, Dermatology Department, Hospital General Universitario Morales Meseguer, Av. Marqués de los Vélez, 30008 Murcia, Spain.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ródenas, J.M., Delgado-Rodríguez, M., Herranz, M.T. et al. Sun exposure, pigmentary traits, and risk of cutaneous malignant melanoma: a case-control study in a Mediterranean population. Cancer Causes Control 7, 275–283 (1996). https://doi.org/10.1007/BF00051303

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00051303

Key words

Navigation