META ANALYSIS OF TIMING OF SUN EXPOSURE AND MELANOMA

描述(申请人的描述)恶性黑色素瘤发病率 在美国，皮肤的增长速度比其他任何癌症都要快。太阳 暴露是导致癌症发生的主要病因风险因素。 黑色素瘤。估计的黑色素瘤新病例和死亡人数 继续上升，辨别出最重要的日照时间和 影响的大小很重要。虽然没有发现新的假设， 对先前的研究进行的Meta分析评估了 潜在的危险因素和黑色素瘤可能有助于指导寻找 未来病例对照研究和预防中的疾病病因 努力。为此，我们需要更好地了解当前的 关于阳光照射的信息和皮肤可能产生的混杂效应 对太阳的敏感性。 研究人员为元分析建议的各种技术可以是 概括为两种方法：重要性层次的组合 以及效果大小的组合。在这项研究中，我们计划研究一种 通过合并相对风险估计来合并效果大小的变化。 将使用加权最小二乘法合并相对风险估计 假设一个固定的效应模型，一个随机效应模型(当研究 异质性)和线性剂量-反应模型。这一行动的总体目标是 建议通过结合以下方式开展与黑色素瘤病因相关的研究 相对风险估计(RR)及其与以前进行的方差 对观察到的数据的强度和一致性进行研究 联想。 黑色素瘤与1)晒伤的时间，2)防晒霜的使用， 3)日光浴沙龙的使用情况，以及4)日光暴露量的累积情况 通过合并每个研究对整体亲属的风险估计来单独进行 风险估计以及按研究设计的组合估计(例如，队列， 病例对照、医院对照和以人口为基础的对照)和方法 数据抽象化。研究还将通过以下方面进行审查： 根据日光敏感度进行调整(皮肤白皙、有灼伤倾向、 不能晒黑等)。当数据可用时，我们还将研究 黑色素瘤与时间关系的可能效应修正 晒伤，2)防晒霜的使用，3)日光浴沙龙的使用，4)累积的阳光 试图更好地理解这一点的重要性 互动。这种潜在的相互作用可能解释了一些相互冲突的 结果发表在文献中。

DESCRIPTION (Applicant's Description) The incidence of malignant melanoma of the skin is increasing faster than any other cancer in the United States. Sun exposure is the major etiologic risk factor implicated in the development of melanoma. As the number of estimated new cases and deaths from melanoma continue to rise, discerning the most important timing of sun exposure and the magnitude of the effect is important. While not uncovering new hypotheses, meta-analyses conducted on previous studies evaluating associations between potential risk factors and melanoma may help to guide the search for the etiologies of this disease in future case-control studies and prevention efforts. For this, we need to have a better understanding of the current information on sun exposure and possible confounding effects of the skin's sensitivity to the sun. The various techniques suggested by researchers for meta-analysis can be generally summarized into two approaches: combination of significance levels and combination of effect sizes. In this study, we plan to look at a variation on combining effect sizes by combining relative risk estimates. Relative risk estimates will be pooled using a weighted least square method assuming a fixed effects model, a random effects model (when studies are heterogeneous) and a linear dose-response model. The overall aims of this proposal are to conduct research relevant to melanoma etiology by combining relative risk estimates (RRs) and their variances from previously conducted studies to examine both the strengths and consistency of the observed associations. The relationship between melanoma and 1) timing of sunburns, 2) sunscreen use, 3) tanning salon use, and 4) cumulative sun exposure will each be examined separately by combining risk estimates from each study for an overall relative risk estimate along with combined estimates by study design (e.g., cohort, case-control, hospital controls, and population-based controls), and by method of data abstraction. Studies will also be examined by whether or not they are adjusted for sun-sensitivity (light complexion, tendency to burn, inability to tan, etc.). When data is available, we will also examine the possible effect modification of the relation between melanoma and 1) timing of sunburns, 2) sunscreen use, 3) tanning salon use, and 4) cumulative sun exposure by sun-sensitivity in an attempt to better understand this important interaction. This potential interaction may explain some of the conflicting results in the literature.