To determine which host characteristics are risk factors for cutaneous malignant melanoma in order to aim prevention and early detection programs at people at high risk.
Case-control study.
Southern Ontario.
The 583 case subjects were aged 20 to 69 years and had had malignant melanoma newly diagnosed between Oct. 1, 1984, and Sept. 30, 1986. The 608 control subjects were randomly selected from a list of residents in the study area and were stratum matched for age, sex and municipality.
Through in-person interviews the interviewer ascertained exposure to putative external risk factors and assessed skin colour and number of nevi on the arm, and the subject reported his or her natural hair colour at age 20 years, eye colour, skin reaction to repeated sun exposure, and freckle and whole-body nevus densities.
Although all the host factors mentioned were significantly associated with melanoma risk when considered separately, only hair colour, skin reaction to repeated sun exposure, and self-reported freckle and nevus densities remained significant after backward logistic regression analysis. The odds ratio for melanoma was estimated to be 10.7 in people who had many nevi compared with those who had none (95% confidence interval [CI] 6.6 to 17.4), 4.0 in people who had red hair compared with those who had black hair (95% CI 1.9 to 8.2), 1.9 in people who had many freckles compared with those who had none or few (95% CI 1.3 to 2.8) and 1.4 respectively in people who burned and had a subsequent increase in tan and those who burned and had no increase in tan after repeated sun exposure compared with those who did not burn [corrected].
Four risk factors for malignant melanoma have been identified. Prospective evaluation of their predictive value should be done. In the meantime, however, these factors should be used to identify people apparently at high risk for malignant melanoma, who can then be targeted for early detection and prevention programs.
Notes
Cites: Br Med J (Clin Res Ed). 1986 Jun 14;292(6535):1555-93087514
Cites: J Am Acad Dermatol. 1990 Jun;22(6 Pt 1):1042-82370329
Cites: J Am Acad Dermatol. 1987 Sep;17(3):459-683655025
Cites: Br J Cancer. 1986 Jan;53(1):65-743947517
Cites: Cancer. 1973 Nov;32(5):1275-864757918
Cites: World Health Stat Q. 1980;33(1):2-267445509
Cites: Int J Epidemiol. 1990 Dec;19(4):801-102084006
Cites: Cancer. 1990 Jan 15;65(2):362-62295059
Cites: Am J Epidemiol. 1990 Feb;131(2):232-432296977
Cites: Lancet. 1989 Aug 26;2(8661):487-902570195
Cites: Lancet. 1985 Oct 19;2(8460):859-632864579
Cites: Int J Cancer. 1988 Aug 15;42(2):200-63403065
Cites: J Epidemiol Community Health. 1987 Dec;41(4):306-113455424
Cites: Am J Epidemiol. 1987 Nov;126(5):901-113661538
Cites: Recent Results Cancer Res. 1986;102:56-753738187
Cites: Int J Cancer. 1985 Mar 15;35(3):297-3003972472
Cites: Br Med J (Clin Res Ed). 1984 Jan 14;288(6411):99-1026419839
Cites: Int J Cancer. 1980 Dec 15;26(6):703-97216539
Cites: BMJ. 1988 Aug 6;297(6645):388-913408978
Cites: Am J Epidemiol. 1991 Feb 1;133(3):240-52000841
Comment In: CMAJ. 1992 Aug 15;147(4):409-101498752
Erratum In: Can Med Assoc J 1992 Dec 15;147(12):1764