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American Journal of Epidemiology Vol. 155, No. 7 : 614-621
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health


ORIGINAL CONTRIBUTIONS

Cutaneous Melanin Density of Caucasians Measured by Spectrophotometry and Risk of Malignant Melanoma, Basal Cell Carcinoma, and Squamous Cell Carcinoma of the Skin

Terence Dwyer1, Leigh Blizzard1, Rosemary Ashbolt1, Juliet Plumb1, Marianne Berwick2 and James M. Stankovich1

1 Menzies Centre for Population Health Research, University of Tasmania, Hobart, Tasmania, Australia.
2 Memorial Sloan-Kettering Cancer Center, New York, NY.

Recent advances have enabled quite accurate estimation by spectrophotometry of the density of cutaneous melanin. The relation between skin cancers and this objective measure of skin phenotype is examined here. For this purpose, a population-based case-control study of subjects aged 20–59 years of northern European ancestry was conducted in Tasmania, Australia. Cases (n = 244) of cutaneous malignant melanoma during 1998–1999, and a sample of cases of basal cell carcinoma (n = 220) and squamous cell carcinoma (n = 195) of the skin were identified from cancer registrations. Controls (n = 483) were selected from a comprehensive population listing. Melanin at the upper inner arm was estimated from skin reflectance of light of 400 and 420 nm wavelengths. For melanoma, basal cell carcinoma, and squamous cell carcinoma, respectively, the odds ratios comparing the least with the highest of four melanin categories were 6.2 (95% confidence interval (CI): 2.3, 16.6), 6.3 (95% CI: 2.6, 15.1), and 4.2 (95% CI: 1.7, 10.8) for men and 1.9 (95% CI: 1.0, 3.7), 1.4 (95% CI: 0.7, 3.0), and 0.7 (95% CI: 0.3, 1.7) for women. The gender differences were not due to disparities in site of occurrence or (for melanoma) in thickness of the lesion. The authors conclude that, particularly for men, cutaneous melanin density at the upper inner arm is a strong predictor of risk of skin cancer.

case-control studies;; melanins;; melanoma;; population;; skin neoplasms

Abbreviations: BCC, basal cell carcinoma of the skin;; CI, confidence interval;; CMM, cutaneous malignant melanoma;; ICD-9, International Classification of Diseases, Ninth Revision;; SCC, squamous cell carcinoma


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