Ambient UVB and Melanoma Risk in the United States: A Case-Control Analysis

Lea, C. Suzanne; Scotto, Joseph A.; Buffler, Patricia A.; Fine, Judith; Barnhill, Raymond L.; Berwick, Marianne

doi:10.1016/j.annepidem.2007.01.030

« Previous Next »Annals of Epidemiology
Volume 17, Issue 6 , Pages 447-453, June 2007

Ambient UVB and Melanoma Risk in the United States: A Case-Control Analysis

From the Department of Epidemiology and Public Health Biology (C.S.L., P.A.B.), University of California, Berkeley, Berkeley, CA; U.S. Public Health Service (retired, Captain) (J.A.S.); Department of Surgery (J.F.), University of Connecticut Health Center , Farmington, CT; Department of Pathology, University of Miami School of Medicine, Miami, FL (R.L.B.); Cancer Research and Treatment Center, Department of Internal Medicine (M.B.), University of New Mexico, Albuquerque, NM; and Research Triangle Institute, International (C.S.L.), Research Triangle Park, NC

Received 9 August 2006; accepted 8 January 2007. published online 02 April 2007.

Purpose

Exposure to ultraviolet-B (UVB) radiation is a well-established risk factor for human cutaneous malignant melanoma. Intermittent and cumulative exposures from UVB have been estimated most often by interview questionnaire. This study assessed cumulative UVB using a ground-based measurement instrument to estimate the association between UVB and melanoma.

Methods

Population-based, incident cases of melanoma (n = 380) and frequency-matched controls (n = 364) residing in Connecticut at diagnosis were interviewed between 1987 and 1989 about recreational and vacation activities, sun-protection practices, occupation, and other factors. Using a residential history, regression estimates of lifetime UVB were derived from ambient measures of UVB, adjusted for intermittent exposure.

Results

Cases and controls received 29% of lifetime mean UVB in the first 15 years of life. Number of days per year in recreational activity during childhood and late adulthood were associated with increased melanoma risk. When estimating lifetime UVB adjusted for intermittent exposure, melanoma risk peaked at a 5.7-fold increased risk in the ninth decile.

Conclusion

Sporadic and chronic sun exposure play a role in melanoma etiology. Skin-protection practices should be encouraged across levels of sun intensity, not only in childhood but throughout adulthood.

Key Words: Malignant Melanoma, Epidemiology, Exposure Assessment, Ultraviolet Rays

Selected Abbreviations and Acronyms: OR, odds ratio, CI, confidence interval, UVR, ultraviolet radiation, UVB, ultraviolet radiation–B, MED, minimum erythemal dose, RB, Robertson–Berger