Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls
Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls
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DOI：
10.1093/ije/dyp166
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发表时间：
2009-06-01
影响因子：
7.7
通讯作者：
Newton-Bishop, Julia A.
中科院分区：
文献类型：
--
作者：
Chang, Yu-mei;Barrett, Jennifer H.;Newton-Bishop, Julia A.
背景黑色素瘤的风险与阳光照射，我们已经调查了肿瘤部位和latitude.Methods的风险变化，我们进行了汇总分析15例病例对照研究（5700黑色素瘤病例和7216对照），相关模式的阳光照射，晒伤和日光性角化病（三项研究）与黑色素瘤的风险。合并优势比（PORs）和95%Bayesian置信区间（CIs）采用Bayesian无条件多分类logistic随机系数模型进行估计。（pOR 1.7; 95% CI：1.4-2.2）和四肢（pOR 1.4; 95% CI：1.1-1.7），但头部和颈部（pOR 1.1; 95% CI：0.8-1.4），跨纬度。在低纬度地区，职业性日光暴露与头颈部黑色素瘤风险相关（pOR 1.7; 95%CI：1.0-3.0）。在低纬度地区，总日照量与四肢黑色素瘤风险增加相关（pOR 1.5; 95%CI：1.0-2.2），但在其他身体部位或其他纬度地区则无关。对于躯干、四肢和头颈部的黑色素瘤，儿童期晒伤的pOR分别为1.5（95%CI：1.3 - 1.7）、1.5（95%CI：1.3-1.7）和1.4（95%CI：1.1-1.7），显示出几乎没有纬度差异。头颈部日光性角化病与头颈部（pOR 4.0; 95% CI：1.7-9.1）和四肢（pOR 4.0; 95% CI：1.9-8.4）黑色素瘤的发病风险相关。在所有纬度地区，长期日光照射和晒伤都是黑色素瘤的强预测因子，而职业和总日光照射的测量似乎主要在低纬度地区预测黑色素瘤。黑色素瘤，娱乐性日光暴露，职业性日光暴露，总日光暴露，晒伤，日光性角化病
Background Melanoma risk is related to sun exposure; we have investigated risk variation by tumour site and latitude.Methods We performed a pooled analysis of 15 case-control studies (5700 melanoma cases and 7216 controls), correlating patterns of sun exposure, sunburn and solar keratoses (three studies) with melanoma risk. Pooled odds ratios (pORs) and 95% Bayesian confidence intervals (CIs) were estimated using Bayesian unconditional polytomous logistic random-coefficients models.Results Recreational sun exposure was a risk factor for melanoma on the trunk (pOR 1.7; 95% CI: 1.4-2.2) and limbs (pOR 1.4; 95% CI: 1.1-1.7), but not head and neck (pOR 1.1; 95% CI: 0.8-1.4), across latitudes. Occupational sun exposure was associated with risk of melanoma on the head and neck at low latitudes (pOR 1.7; 95% CI: 1.0-3.0). Total sun exposure was associated with increased risk of melanoma on the limbs at low latitudes (pOR 1.5; 95% CI: 1.0-2.2), but not at other body sites or other latitudes. The pORs for sunburn in childhood were 1.5 (95% CI: 1.3-1.7), 1.5 (95% CI: 1.3-1.7) and 1.4 (95% CI: 1.1-1.7) for melanoma on the trunk, limbs, and head and neck, respectively, showing little variation across latitudes. The presence of head and neck solar keratoses was associated with increased risk of melanoma on the head and neck (pOR 4.0; 95% CI: 1.7-9.1) and limbs (pOR 4.0; 95% CI: 1.9-8.4).Conclusion Melanoma risk at different body sites is associated with different amounts and patterns of sun exposure. Recreational sun exposure and sunburn are strong predictors of melanoma at all latitudes, whereas measures of occupational and total sun exposure appear to predict melanoma predominately at low latitudes. Keywords Melanoma, recreational sun exposure, occupational sun exposure, total sun exposure, sunburn, solar keratoses