Clinical Epidemiology of Melanoma

Abstract

Melanomas are common cancers among people of European ancestry, and incidence has been rising in most populations where fair-skinned people predominate. The principal environmental risk factor for cutaneous melanoma is solar ultraviolet radiation, although the association is nonlinear and modified by host factors. While overall, fair-skinned populations residing in regions of high ambient insolation have higher rates of melanoma than those residing in regions receiving less sunlight, it is also generally observed that outdoor workers have lower risks of melanoma than indoor workers. A suite of host phenotypic characteristics confer increased relative risks of melanoma including fair complexion, skin that burns and does not tan, red hair, freckling, and blue eyes. Those with a propensity for developing large numbers of melanocytic nevi also have markedly increased risks of melanoma. Recently, algorithms have been developed that combine information about various phenotypic characteristics to derive an overall summary risk score. Such tools are being tested as decision aids to stratify individuals into potential screening programs according to their future risk of melanoma.