Table Of ContentEPIDEMIOLOGICAL ASPECTS
OF CUTANEOUS
MALIGNANT MELANOMA
Developments in Oncology
52. M. Chatel, F. Darcel and J. Peeker (eds.): Brain Oncology. Biology, Diagnosis
and Therapy. 1987 ISBN 0-89838-954-2
53. M.P. Hacker, J.S. Lazo and T.R. Tritton (eds.): Organ Directed Toxicities of
Anticancer Drugs. 1988 ISBN 0-89838-356-0
54. M. Nicolini (ed.): Platinum and Other Metal Coordination Compounds in Cancer
Chemotherapy. 1988 ISBN 0-89838-358-7
55. J.R. Ryan and L.O. Baker (eds.): Recent Concepts in Sarcoma Treatment. 1988
ISBN 0-89838-376-5
56. M.A. Rich, J.C. Hager and D.M. Lopez (eds.): Breast Cancer. Scientific and
Clinical Aspects. 1988 ISBN 0-89838-387-0
57. B.A. Stoll (ed.): Women at High Risk to Breast Cancer. 1989
ISBN 0-89838-416-8
58. M.A. Rich, J.C. Hager and I. Keydar (eds.): Breast Cancer. Progress in
Biology, Clinical Management and Prevention. 1989 ISBN 0-7923-0507-8
59. P.1. Reed, M. Carboni, BJ. Johnston and S. Guadagni (eds.): New Trends in
Gastric Cancer. Background and Videosurgery. 1990 ISBN 0-7923-8917-4
60. H.K. Awwad: Radiation Oncology: Radiobiological and Physiological
Perspectives. The Boundary-Zone between Clinical Radiotherapy and
Fundamental Radiobiology and Physiology. 1990 ISBN 0-7923-0783-6
61. J.L. Evelhoch, W. Negendank, F.A. Valeriote and L.H. Baker (eds.): Magnetic
Resonance in Experimental and Clinical Oncology. 1990 ISBN 0-7923-0935-9
62. B.A. Sto\l (ed.): Approaches to Breast Cancer Prevention. 1991
ISBN 0-7923-0995-2
63. M.J. Hill and A. Giacosa (eds.): Causation and Prevention of Human Cancer.
1991 ISBN 0-7923-1084-5
64. J.R.W. Masters (ed.): Human Cancer in Primary Culture. A Handbook. 1991
ISBN-O-7923-1088-8
65. N. Kobayashi, T. Akera and S. Mizutani (eds.): Childhood Leukemia. Present
Problems and Future Prospects. 1991 ISBN 0-7923-1138-8
66. P. Paoletti, K. Takakura, M.D. Walker, G. Butti and S. Pezzotta (eds.): Neuro-
oncology. 1991 ISBN 0-7923-1215-5
67. K.V. Honn, L.J. Marnett, S. Nigam and T. Walden Jf. (eds.): Eicosanoids and
Other Bioactive Lipids in Cancer and Radiation Injury. 1991
ISBN 0-7923-1303-8
68. F.A. Valeriote, T.H. Corbett and L.H. Baker (eds.): Cytotoxic Anticancer
Drugs: Models and Concepts for Drug Discovery and Development. 1992
ISBN 0-7923-1629-0
69. L. Dogliotti, A. Sapino and G. Bussolati (eds.): Breast Cancer. Biological and
Clinical Progress. 1992 ISBN 0-7923-1655-X
70. E. Benito, A. Giacosa and M.J. Hill (eds.): Public Education on Diet and
Cancer. 1992 ISBN 0-7923-8997-2
71. S. Nigam, K.V. Honn, L.J. Morvett and Th.L. Walden, Jr. (eds.): Eicosanoids
and Other Bioactive Lipids in Cancer, Inflammation and Radiation Injury. 1992
ISBN 0-7923-1870-6
72. F.H. Menko: Genetics of Colorectal Cancer for Clinical Practice. 1993
ISBN 0-7923-2100-6
73. R.P. Gallagher and J .M. Elwood (eds.): Epidemiological Aspects of Cutaneous
Malignant Melanoma. 1994 ISBN 0-7923-2740-3
KLUWER ACADEMIC PUBLISHERS-DORDRECHT/BOSTON/LONDON
Epidemiological Aspects
оС
Cutaneous Malignant Melanoma
edited
ьу
Richard Gallagher
Р.
British Cancer Agency
СоlUПlЫа
Vancouver, British Canada
СоlUПlЫа,
and
J. Mark Elwood
University of Otago
Dunedin, New Zealand
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging-in-Publication Data
Epidemiological aspects of cutaneous malignant melanoma / edited Ьу
Richard Р. Gallagher and J. Mark Elwood.
р. ст. -- (Developments in oncology ; 73)
Includes bibliographical references and index.
ISBN 978-1-4613-6126-8 ISBN 978-1-4615-2626-1 (eBook)
DOI 10.1007/978-1-4615-2626-1
1. Melanoma--Epidemiology. 1. Gallagher, R. Р. (Richard Р.),
1944- . п. Elwood, J. Mark. III. Series.
[DNLM: 1. Melanoma--etiology. 2. Skin Neoplasms--etiology. Wl
DE998N у. 73 1994 / WR 500 Е64 1994]
RC280.M37E65 1994
616. 99'477--dc20
DNLM/DLC
for Library of Congress 94-3133
CIP
Copyright @ 1994 Springer Science+Business Media New York
Originally published Ьу К1uwer Academic Publishers in 1994
Softcover reprin1 of the hardcover 1s 1 edi1ion 1994
АН rights reserved. No part of this publication тау Ье reproduced, stored in
а retrieval system or transmitted in anу form or Ьу anу means, mechanical,
photo-copying, recording, or otherwise, without the prior written permission of
the publisher, Springer Science+Business Media, LLC.
Printed acid-free
оп рарег.
CONTENTS
PREFACE IX
CONTRIBUTING AUTHORS XI
I. Recent Progress in Melanoma Research
1. Recent progress in the epidemiology of malignant melanoma. 3
RICHARD P. GALLAGHER and J. MARK. ELWOOD
II. Solar and Artificial Ultraviolet Radiation and Melanoma
2. Sun exposure and the epidemiology of malignant 15
melanoma.
J. MARK. ELWOOD and RICHARD P. GALLAGHER
3. Etiological clues from the anatomical distribution of 67
cutaneous melanoma.
ADELE GREEN and ROBERT MACLENNAN
4. Tables of ambient solar ultraviolet radiation for use in 81
epidemiological studies of malignant melanoma.
BRIAN L. DIFFEY and J. MARK. ELWOOD
5. Non-solar sources of ultraviolet radiation and cutaneous 107
malignant melanoma: a review of the evidence
LORAINE D. MARRETT
III. Nevi and Melanoma
6. Risk factors for prevalence of nevi: a review. 131
LESLIE K. DENNIS and EMILY WHITE
7. The atypical mole syndrome -a definition of phenotype 151
JULIA A. NEWTON and VERONIQUE BATAILLE
v
8. Risk of cutaneous m~lanomll, by number of 159
melanocytic nevi and correlation of nevi by anatomic site
ELIZABETH A. HOLLY, JOHN W. KELLY,
DAVID K. AHN, STEVEN N. SHPALL nd JUDITH I. ROSEN
IV Occupation and Melanoma
1
9. Malignant melanoma of the skin in the 175
telecommunications industry
LOUISE DE GUIRE
10. Petroleum refinery exposure and risk of malignant 187
melanoma
MARGARET M. HORNSTRA, MARK J. KLAN and
DANS. SHARP
11. Methods for evaluating confounding and effect 193
modification in a small occupational study of
cutaneous malignant melanoma
JUDITH A. SCHWARTZBAUM, R. WOODROW SETZER
and LAWRENCE L. KUPPER
V. Pregnancy and Hormonal Factors and Melanoma
12. Melanoma and pregnancy 209
ELIZABETH A. HOLLY and ROSEMARY D. CRESS
13. Cutaneous melanoma and oral contraceptives 223
ELIZABETH A. HOLLY
VI. Diet and Melanoma
14. Epidemiology of diet and melanoma incidence -a brief review 243
CONSTANCE S. KIRKPATRICK
15. Dietary and other correlates of melanoma in Hawaii: 253
preliminary findings
LOIC LE MARCHAND, JEAN H. HANKIN,
LAURENCE N. KOLONEL and LYNNE R. WILKENS
VII. Prevention and Early Detection of Melanoma
16. Early detection and lethal melanoma in Connecticut: 265
a preliminary analysis
MARIANNE BERWICK, NEIL DUBIN,
GEORGE ROUSH and RAYMOND BARNHILL
vi
17. Risk factors for presentation with thick primary 273
melanoma include older age, male sex, smoking,
and may include occupation in certain industries
PETER HERSEY, TIMOTHY STRONG,
DUNCAN GRANT and ZINNY MARlSH
18. Skin cancer screening in Massachusetts: 289
the program and methodologic questions
HOWARD K. KOH, DONALD R. MILLER,
ALAN C. GELLER and ROBERT A. LEW
VIII. Future Directions in Melanoma Research
19. The epidemiology of melanoma: 307
where do we go from here?
BRUCE K. ARMSTRONG
INDEX PAGE 325
vii
PREFACE
S
ignificant progress bas been made in recent years in understanding
tbe origins of cutaneous malignant melanoma. Our knowledge of the
relationship between solar radiation and melanoma has undergone
profound change and it now appears that both the character and timing of
exposure may be more important than total cumulative dose in accounting for
risk. The melanoma-sunlight model currently emerging from this research may
prove an instructive heuristic exercise for environmental epidemiology; as we
currently tend to restrict ourselves to searches for uniform total dose response
relationships between cancers and suspected environmental carcinogens.
The study of the relationship between acquired melanocytic nevi and
melanoma which began about 15 years ago has led to useful new information
about predictors of melanoma risk, and in addition bas opened new perspec
tives on the development of nevi in children. Definition of the factors for nevus
development in children may lead to the possibility of primary prevention
programs for melanoma in younger generations of children.
Recent new evidence has surfaced suggesting that certain occupational
groups, including electrical and electronic workers as well as chemists and
petroleum refinery workers may be at elevated risk of melanoma. These leads
should be vigorously pursued.
A great deal of work is going into the study of ways of screening high
risk populations in order to detect melanoma at its earliest stages when current
treatment protocols are most effective. The visibility of lesions on the skin
challenges classical definitions of early detection and screening in epidemiol
ogy.
We acknowledge financial help with this book from a number of sources
including Westwood-Squibb Pharmaceuticals, Ortho-McNeil Inc., Bristol
Laboratories of Canada, Health Canada (Action Plan on Health and the Envi
ronment), and the Canadian Melanoma Foundation, and the Jambor Knowl
edge Fund of the British Colwnbia Cancer Agency.
We would like to thank Shirley Morton, Jane Duke and Jean van den
Broek for administrative support throughout the preparation of the book, and
Rose Antonelli and Jeffrey Smith of Kluwer Academic Publishers for advice
during the project. Finally, we would like to acknowledge the invaluable
contribution of David Lewis of Merlin Communications who formatted and
styled the book.
RICHARD P. GALLAGHER
J. MARK ELWOOD
ix
CONTRIBUTING AUTHORS
AHN, David K., Department of Epidemiology and Biostatistics, School of
Medicine, University of California, San Francisco, CA 94143, USA
ARMSTRONG, Bruce K., Australian Institute of Health and Welfare, GPO Box
570, Canberra ACT 2601, Australia
BARNHILL, Raymond, Brigham and Women's Hospital, Harvard University
Medical School, Boston, MA, USA
BATAILLE, Veronique, The Imperial Cancer Research Fund Skin Tumour
Laboratory, Department of Dermatology, Royal London Hospital,
Whitechapel, London El lBB, UK
BERWICK, Marianne, Cancer Prevention Research Institute, 1136 East 22nd
Street, 5th Floor, New York, NY 10010, USA, and Department of
Environmental Medicine, New York University Medical Center,
New York, NY.
CRESS, Rosemary D., Department of Epidemiology and Biostatistics, School of
Medicine, University of California, San Francisco, CA 94143, USA
DE GUIRE, Louise, Department of Community Health, Sacre-Coeur Hospital,
5945 Gouin West, Suite 200, Montreal, Quebec, H4J lE5, CANADA
DENNIS, Leslie K., Department of Family Medicine, Oregon Health Sciences
University, 3181 S.w. Sam Jackson Park Road, Portland, Oregon,
97201-3098, USA
DIFFEY, Brian L., Regional Medical Physics Department, Drybum Hospital,
Durham, DHI 5TW, ENGLAND
DUBIN, Neil, Cancer Prevention Research Institute, 36 East 22nd Street, 5th
Floor, New York, NY 10010, USA, and Department of Environmental
Medicine, New York University Medical Center, New York, NY.
ELWOOD, J. Mark, Hugh Adam Cancer Epidemiology Unit, Department of
Preventive and Social Medicine, Otago Medical School, University of
Otago, PO Box 913, Dunedin, NEW ZEALAND
GALLAGHER, Richard P., Section of Epidemiology, British Columbia Cancer
Agency, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, CANADA,
and Department of Health Care and Epidemiology, University of British
Columbia, Vancouver, BC, CANADA
GELLER, Alan C., Boston University Schools of Medicine and Public Health,
Boston, MA 02118, USA
GRANT, Duncan, Newcastle Melanoma Unit, Immunology and Oncology Unit,
Level 4, David Maddison Building, Royal Newcastle Hospital,
Newcastle, NSW 2300, AUSTRALIA
GREEN, Adele, Epidemiology Unit, Queensland Institute of Medical Research,
Brisbane, Queensland 4029, AUSTRALIA
HANKIN, Jean H., Epidemiology Program, Cancer Research Center of Hawaii,
University of Hawaii at Manoa, Suite 407, 1236 Lauhala Street,
Honolulu, Hawaii, 96813, USA
HERSEY, Peter, Newcastle Melanoma Unit, Immunology and Oncology Unit,
xi
Level 4, David Maddison Building, Royal Newcastle Hospital,
Newcastle, NSW 2300, AUSTRALIA
HOLLY, Elizabeth A., University of California, Cancer Epidemiology Studies,
1388 Sutter Street, Suite 920, San Francisco, CA 94109, USA (Dept of
Epidemiology & Biostatistics, School of Medicine, University of
California, San Francisco, CA 94143, USA).
HORNSTRA, Margaret M., Amoco Corporation, Medical Department, Mail
Code 3805, 200 East Randolph Drive, Chicago, IL 60680-0703, USA
w.,
KELLY, John Monash University Department of Medicine, and the Alfred
Hospital, Melbourne, AUSTRALIA
KIRKPATRICK, Constance S., Good Samaritan Hospital, 407-14th Avenue
Southeast, PO Box 1247, Puyallup, WA 98371-0192, USA
KLAN, Mark J., Amoco Corporation, Medical Department, Chicago, IL 60680,
USA
KOH, Howard K., Boston University School of Medicine, 80 East Concord
Street, C-3, Boston, MA 02118, USA, and The Skin Oncology Program,
Boston University Medical Center, Boston, MA, USA
KOLONEL, Laurence N., Epidemiology Program, Cancer Research Center of
Hawaii, University of Hawaii at Manoa, Suite 407, 1236 Lauhala Street,
Honolulu, Hawaii, 96813, USA
KUPPER, Lawrence L., Department of Biostatistics, University of North
Carolina, Chapel Hill, NC, USA
LE MARCHAND, Loic, Epidemiology Program, Cancer Research Center of
Hawaii, University of Hawaii at Manoa, Suite 407, 1236 Lauhala Street,
Honolulu, Hawaii, 96813, USA
LEW, Robert A., Boston University Schools of Medicine and Public Health,
Boston, MA 02118, USA
MACLENNAN, Robert, Epidemiology Unit, Queensland Institute of Medical
Research, Brisbane, Queensland 4029, AUSTRALIA
MARISH, Zinny, Newcastle Melanoma Unit, Immunology and Oncology Unit,
Level 4, David Maddison Building, Royal Newcastle Hospital,
Newcastle, NSW 2300, AUSTRALIA
MARRETT, Loraine D., Descriptive Epidemiology Unit, Ontario Cancer
Treatment and Research Foundation, 620 University Avenue, Toronto,
ON, M5G 2L7, CANADA
MILLER, Donald R., Boston University Schools of Medicine and Public
Health, Boston, MA 02118, USA
NEWTON, Julia A., The Imperial Cancer Research Fund Skin Tumour
Laboratory, Department of Dermatology, Royal London Hospital,
Whitechape1, London E1 1BB, UK
ROSEN, Judith I., Department of Epidemiology and Biostatistics, School of
Medicine, University of California, San Francisco, CA 94143, USA
ROUSH, George, Cancer Prevention Research Institute, 36 East 22nd Street,
5th Floor, New York, NY 10010, USA, and Department of
Environmental Medicine, New York University Medical Center,
xii
