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dc.contributor.authorGhiasvand, Reza
dc.contributor.authorRobsahm, Trude Eid
dc.contributor.authorGreen, Adele
dc.contributor.authorRueegg, Corina Silvia
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorLund, Eiliv
dc.contributor.authorVeierød, Marit Bragelien
dc.date.accessioned2019-02-11T09:01:43Z
dc.date.available2019-02-11T09:01:43Z
dc.date.embargoEndDate2019-11-22
dc.date.issued2018-09-10
dc.description.abstract<p><i>Importance</i>: Two pathways have been hypothesized for the development of cutaneous melanoma: one typically affects the head and neck, a site with chronic sun damage, and the other affects the trunk, which is less exposed to the sun. However, the possible cause of limb melanomas is less studied under this hypothesis.</p> <p><i>Objective</i>: To investigate the association between phenotypic characteristics, pattern of UV radiation exposure, and risk of melanoma on different body sites.</p> <p><i>Design, Setting, and Participants</i>: This study used data on 161 540 women with information on phenotypic characteristics and UV radiation exposure who were part of the Norwegian Women and Cancer study, a population-based prospective study established in 1991 with exposure information collected by questionnaires at baseline and every 4 to 6 years during follow-up through 2015. Data analysis was performed from October 2017 through May 2018.</p> <p><i>Exposures</i>: Participants reported hair color, eye color, untanned skin color, number of small symmetric and large asymmetric nevi, and freckling, as well as histories of sunburns, sunbathing vacations, and indoor tanning in childhood, adolescence, and adulthood.</p> <p><i>Main Outcomes and Measures</i>: The Norwegian Women and Cancer study was linked to the Cancer Registry of Norway for data on cancer diagnosis and date of death or emigration. Primary melanoma site was categorized as head and neck, trunk, upper limbs, and lower limbs.</p> <p><i>Results</i>: During follow-up of the 161 540 women in the study (mean age at study entry, 50 years [range, 34-70 years]; mean age at diagnosis, 60 years [range, 34-87 years]), 1374 incident cases of melanoma were diagnosed. Having large asymmetric nevi was a significant risk factor for all sites and was strongest for the lower limbs (relative risk [RR], 3.38; 95% CI, 2.62-4.38) and weakest for the upper limbs (RR, 1.96; 95% CI, 1.22-3.17; P = .02 for heterogeneity). Mean lifetime number of sunbathing vacations was significantly associated with risk of trunk melanomas (RR, 1.14; 95% CI, 1.07-1.22) and lower limb melanomas (RR, 1.12; 95% CI, 1.05-1.19) but not upper limb melanomas (RR, 0.98; 95% CI, 0.88-1.09) and head and neck melanomas (RR, 0.87; 95% CI, 0.73-1.04; P = .006 for heterogeneity). Indoor tanning was associated only with trunk melanomas (RR for the highest tertile, 1.49; 95% CI, 1.16-1.92) and lower limb melanomas (RR for the highest tertile, 1.33; 95% CI, 1.00-1.76; P = .002 for heterogeneity). Skin color, hair color, small symmetric nevi, and history of sunburns were associated with risk of melanoma on all sites.</p> <p><i>Conclusions and Relevance</i>: These results appear to support the hypothesis of divergent pathways to melanoma and that recreational sun exposure and indoor tanning are associated with melanoma on the lower limbs, the most common site of melanoma in women. These findings appear to have important preventive implications.en_US
dc.description.sponsorshipThe Norwegian Cancer Society The Institute of Basic Medical Sciences, University of Osloen_US
dc.descriptionSource at <a href=https://doi.org/10.1001/jamadermatol.2018.3964> https://doi.org/10.1001/jamadermatol.2018.3964</a>.en_US
dc.identifier.citationGhiasvand, R., Robsahm, T.E.., Green, A.C., Rueegg, C.S., Weiderpass, E., Lund, E. & Veierød, M.B. (2019). Association of phenotypic characteristics and UV radiation exposure with risk of melanoma on different body sites. <i>JAMA dermatology, 155</i>(1), 39-49. https://doi.org/10.1001/jamadermatol.2018.3964en_US
dc.identifier.issn2168-6068
dc.identifier.issn2168-6084
dc.identifier.otherFRIDAID 1660484
dc.identifier.other10.1001/jamadermatol.2018.3964
dc.identifier.urihttps://hdl.handle.net/10037/14668
dc.language.isoengen_US
dc.publisherAmerican Medical Association (AMA)en_US
dc.relation.journalJAMA dermatology
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7-PEOPLE/609020/EU/SCIENTIA-FELLOWS: International Postdoctoral Fellowship Programme/SCIENTIA-FELLOWS/en_US
dc.rights.accessRightsembargoedAccessen_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800en_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Oncology: 762en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Onkologi: 762en_US
dc.titleAssociation of phenotypic characteristics and UV radiation exposure with risk of melanoma on different body sitesen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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