MALIGNANT MELANOMA IN DENMARK

The age-standardized incidence rate of cutaneous malignant melanoma (CMM) in Denmark increased five- to six-fold between 1943 and 1982. The increase varied by sex and by site, being particularly pronounced for areas of the body normally covered by clothes. A steep increase in risk was revealed for successively younger birth cohorts. Lack of consistency between descriptive epidemiology and indicators for cumulative exposure to sunlight has led to the intermittent exposure hypothesis. Our populationbased case-control study, including 474 incident cases of CMM and 926 controls, has further supported this hypothesis and demonstrated that sunbathing is associated with an increased risk of CMM, particularly during childhood and if it leads to sunbuming. In addition, the risk of CMM is increased in persons with many pigmented naevi and/or a tendency to freckling. Our study does not support a relationship between CMM and hormonal exposure in women and no association was observed between dietary factors, alcohol intake, tobacco smoking, bathing habits or hair dye use and CMM risk.

[1]  J. Spinelli,et al.  Rethinking recycling. , 1995, Environmental health perspectives.

[2]  V. Siskind,et al.  Sunburn and malignant melanoma. , 1985, British Journal of Cancer.

[3]  J. Liff,et al.  Cutaneous melanoma in relation to exogenous hormones and reproductive factors. , 1983, Journal of the National Cancer Institute.

[4]  B. Armstrong,et al.  Relationship of cutaneous malignant melanoma to individual sunlight-exposure habits. , 1986, Journal of the National Cancer Institute.

[5]  M. Tucker,et al.  The Danish case‐control study of cutaneous malignant melanoma. I. Importance of host factors , 1988, International journal of cancer.

[6]  V. Siskind,et al.  Common acquired naevi and the risk of malignant melanoma , 1985, International journal of cancer.

[7]  Jensen Om,et al.  Trends in malignant melanoma of the skin. , 1980 .

[8]  Lancaster Ho,et al.  Some geographical aspects of the mortality from melanoma in Europeans. , 1956 .

[9]  R. Snell,et al.  The effect of large doses of estrogen and estrogen and progesterone on melanin pigmentation. , 1960, The Journal of investigative dermatology.

[10]  D. English,et al.  Cutaneous malignant melanoma and fluorescent lighting. , 1985, Journal of the National Cancer Institute.

[11]  J. Elwood,et al.  Sunburn, suntan and the risk of cutaneous malignant melanoma--The Western Canada Melanoma Study. , 1985, British Journal of Cancer.

[12]  T. Hakulinen,et al.  Sunlight as a risk factor of malignant melanoma of the skin , 1978, Cancer.

[13]  A Breslow,et al.  Thickness, Cross‐Sectional Areas and Depth of Invasion in the Prognosis of Cutaneous Melanoma , 1970, Annals of surgery.

[14]  H. Nelson,et al.  SUNLIGHT AS A CAUSE OF MELANOMA: A CLINICAL SURVEY , 1957, Medical Journal of Australia.

[15]  S. Shapiro,et al.  Lack of an elevated risk of malignant melanoma in relation to oral contraceptive use. , 1984, Journal of the National Cancer Institute.

[16]  T. Sorahan,et al.  The aetiological significance of sunlight and fluorescent lighting in malignant melanoma: a case-control study. , 1985, British Journal of Cancer.

[17]  J. Elwood,et al.  Site distribution of malignant melanoma. , 1983, Canadian Medical Association journal.

[18]  A. Osterlind,et al.  Trends in incidence of malignant melanoma of the skin in Denmark 1943-1982. , 1986, Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer.

[19]  J. Kirkwood,et al.  Demographic study of clinically atypical (dysplastic) nevi in patients with melanoma and comparison subjects. , 1985, Cancer research.

[20]  V. Beral,et al.  Oral contraceptive use and malignant melanoma in Australia. , 1984, British Journal of Cancer.

[21]  A. Green,et al.  Hormonal factors and melanoma in women , 1985, The Medical journal of Australia.

[22]  B. Pasternack,et al.  Epidemiology of malignant melanoma: pigmentary traits, ultraviolet radiation, and the identification of high-risk populations. , 1986, Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer.

[23]  W. Clark,et al.  Dysplastic nevus syndrome: A phenotypic association of sporadic cutaneous melanoma , 1980, Cancer.

[24]  W. Clark,et al.  The developmental biology of induced malignant melanoma in guinea pigs and a comparison with other neoplastic systems. , 1976, Cancer research.

[25]  J. Collins,et al.  Period and cohort factors in the incidence of malignant melanoma in the state of Connecticut. , 1984, Environmental health perspectives.

[26]  R. Baxter,et al.  DIETARY POLYUNSATURATED FATS AND MALIGNANT MELANOMA , 1980, The Medical journal of Australia.

[27]  M. Tucker,et al.  The Danish case‐control study of cutaneous malignant melanoma. III. Hormonal and reproductive factors in women , 1988, International journal of cancer.

[28]  RogerR. Williams,et al.  BREAST AND THYROID CANCER AND MALIGNANT MELANOMA PROMOTED BY ALCOHOL-INDUCED PITUITARY SECRETION OF PROLACTIN, T.S.H., AND M.S.H. , 1976, The Lancet.

[29]  J Siemiatycki,et al.  Statistical methods for relating several exposure factors to several diseases in case-heterogeneity studies. , 1986, Statistics in medicine.

[30]  C. la Vecchia,et al.  Risk factors for cutaneous malignant melanoma in a northern italian population , 1987, International journal of cancer.

[31]  V. Beral,et al.  MALIGNANT MELANOMA AND EXPOSURE TO FLUORESCENT LIGHTING AT WORK , 1982, The Lancet.

[32]  R. Williams,et al.  Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. , 1977, Journal of the National Cancer Institute.

[33]  H. Shaw,et al.  Smoking and the development of metastases from malignant melanoma , 1981, International Journal of Cancer.

[34]  N. Cook,et al.  Sun exposure habits in patients with cutaneous melanoma: a case control study. , 1983, The Journal of dermatologic surgery and oncology.

[35]  R. Johr,et al.  Lentigo maligna and lentigo maligna melanoma , 1997 .

[36]  P. Nestel,et al.  DO POLYUNSATURATED FATS PREDISPOSE TO MALIGNANT MELANOMA? , 1976, The Medical journal of Australia.

[37]  K. Hou‐Jensen,et al.  Incidence of cutaneous malignant melanoma in Denmark 1978-1982. Anatomic site distribution, histologic types, and comparison with non-melanoma skin cancer. , 1988, British Journal of Cancer.

[38]  S. Duffy,et al.  Risk of breast cancer in relation to reproductive factors in Denmark. , 1988, British Journal of Cancer.

[39]  K. Magnus.  Incidence of malignant melanoma of the skin in Norway, 1955–1970. Variations in time and space and solar radiation , 1973, Cancer.

[40]  R. Paffenbarger,et al.  Characteristics in youth predictive of adult-onset malignant lymphomas, melanomas, and leukemias: brief communication. , 1978, Journal of the National Cancer Institute.

[41]  R. Stevens,et al.  The influence of age, year of birth, and date on mortality from malignant melanoma in the populations of England and Wales, Canada, and the white population of the United States. , 1979, American journal of epidemiology.

[42]  V. Beral,et al.  Cutaneous factors related to the risk of malignant melanoma , 1983, The British journal of dermatology.

[43]  C. Kay.  Malignant melanoma and oral contraceptives , 1981, British Journal of Cancer.

[44]  M. Tucker,et al.  The Danish case‐control study of cutaneous malignant melanoma. IV. No association with nutritional factors, alcohol, smoking or hair dyes , 1988, International journal of cancer.

[45]  N. de Klerk,et al.  Etiology of common acquired melanocytic nevi: constitutional variables, sun exposure, and diet. , 1986, Journal of the National Cancer Institute.

[46]  T. Fears,et al.  Skin cancer epidemiology: research needs. , 1978, National Cancer Institute monograph.

[47]  W. Willett,et al.  Oral contraceptive use and malignant melanoma. , 1982, Journal of the National Cancer Institute.

[48]  W. Clark,et al.  PRECURSOR NAEVI IN CUTANEOUS MALIGNANT MELANOMA: A PROPOSED NOMENCLATURE , 1980, The Lancet.

[49]  B K Armstrong,et al.  Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. , 1984, Journal of the National Cancer Institute.

[50]  C. Beattie,et al.  Estrogen receptor in malignant melanoma. , 1987, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[51]  G. Eklund,et al.  Sunlight and incidence of cutaneous malignant melanoma. Effect of latitude and domicile in Sweden. , 1978, Scandinavian journal of plastic and reconstructive surgery.

[52]  S. Vesselinovitch,et al.  The induction of malignant melanomas in Syrian white hamster by neonatal exposure to urethan. , 1970, Cancer research.

[53]  E. Saxén,et al.  Do the predictions for cancer incidence come true? experience from Finland , 1986, Cancer.

[54]  M. Tucker,et al.  The Danish case‐control study of cutaneous malignant melanoma. II. Importance of UV‐light exposure , 1988, International journal of cancer.

[55]  H. Storm,et al.  Cancer registration in Denmark and the study of multiple primary cancers, 1943-80. , 1985, National Cancer Institute monograph.

[56]  G. Engholm,et al.  Trends in cutaneous malignant melanoma in Denmark 1943–1982 by anatomic site , 1988, APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.

[57]  J J Spinelli,et al.  Pigmentation and skin reaction to sun as risk factors for cutaneous melanoma: Western Canada Melanoma Study. , 1984, British medical journal.

[58]  D Clayton,et al.  Models for temporal variation in cancer rates. I: Age-period and age-cohort models. , 1987, Statistics in medicine.

[59]  G A Gellin,et al.  Malignant melanoma. A controlled study of possibly associated factors. , 1969, Archives of dermatology.

[60]  B. Armstrong,et al.  Hutchinson's melanotic freckle melanoma associated with non-permanent hair dyes. , 1983, British Journal of Cancer.

[61]  H. Storm,et al.  Completeness of cancer registration in Denmark 1943-1966 and efficacy of record linkage procedures. , 1988, International journal of epidemiology.

[62]  J. Elwood,et al.  Cutaneous melanoma in relation to intermittent and constant sun exposure—the western canada melanoma study , 1985, International journal of cancer.

[63]  V. Beral,et al.  Malignant melanoma and oral contraceptive use among women in California. , 1977, British Journal of Cancer.

[64]  I. Crombie.  Variation of melanoma incidence with latitude in North America and Europe. , 1979, British Journal of Cancer.

[65]  R. MacKie,et al.  Severe sunburn and subsequent risk of primary cutaneous malignant melanoma in scotland. , 1982, British Journal of Cancer.

[66]  B. Macmahon,et al.  Attributable risk percent in case-control studies. , 1971, British journal of preventive & social medicine.

[67]  S. Moolgavkar,et al.  Cohort analysis of malignant melanoma in five countries. , 1984, American journal of epidemiology.

[68]  N. Day,et al.  Mathematical modelling of malignant melanoma trends in Norway, 1953-1978. , 1983, American journal of epidemiology.

[69]  O. Klepp,et al.  Some environmental and bodily characteristics of melanoma patients. A case‐control study , 1979, International journal of cancer.

[70]  B. Armstrong,et al.  An analysis of trends in mortality from malignant melanoma of the skin in Australia , 1980, International journal of cancer.

[71]  N. Breslow,et al.  Statistical methods in cancer research: volume 1- The analysis of case-control studies , 1980 .

[72]  O. M. Jensen,et al.  Increasing incidence of trunk melanoma in young Danish women. , 1987, British Journal of Cancer.

[73]  Benign melanocytic naevi as a risk factor for malignant melanoma. , 1986 .

[74]  B. Armstrong,et al.  A theory of the etiology and pathogenesis of human cutaneous malignant melanoma. , 1983, Journal of the National Cancer Institute.