Melanoma - Some Interesting Associations

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Melanoma - Some Interesting Associations

The 'epidemic' of melanoma between under- and overdiagnosis

With the sun starting to shine again, the eternal question of skin cancer danger inevitably arises. There are many issues surrounding melanoma and sun exposure, including what relationship actually exists. This study is looking specifically at overdiagnosis - there has been an incredible increase in melanoma cases, however little to no increase in deaths, meaning that we are diagnosing lesions that never would have progressed.

Also important is to look at sun exposure and melanoma, which will not give you the connection you're expecting. See below for more. You can't read these 3 reviews and not question what you've been taught.

"The increased incidence of cutaneous malignant melanoma, together with only minor changes in mortality, has brought into question the existence of a melanoma epidemic. The discrepancy between incidence and mortality suggests that most newly diagnosed melanomas have indolent behaviour....These studies all report an increase in incidence of melanoma during the last few decades, with by far the highest increase in tumours at a very early stage (T1 or IA). Little or no change was seen in mortality. However, increases in both mortality and incidence of thick melanomas were found in the oldest subgroups, especially in men. These findings indicate the existence of a certain degree of overdiagnosis of melanoma. They also indicate the existence of two different types of epidemic, for younger and older subgroups."

A link to the research article is here and a related article with a similar conclusion is here .


Melanoma Cancer Rates by State

This is a map of melanoma rates by state from the Centers for Disease Control. Note the lack of association with UV or sun exposure. We've lived in the Northeast, Seattle, and Phoenix, and statistically the chance of getting melanoma is higher in the Northeast and cloudy Seattle than it is in Arizona, and most of the Southwest.

Melanoma is a multi-factorial disease that is not simply related to sun exposure.


Occupational sun exposure and risk of melanoma

Another study showing that the association between sun exposure and melanoma is far more complex than is usually thought. A map showing melanoma rates by state is which should make that obvious is here.

This is another study showing that people who get consistent sun exposure do not have higher rates of melanoma. It's the intermittent sun exposure that is the risk - staying out of the sun and than getting burnt those few times is more of an issue than getting sun exposure regularly and building a tan.

"Although sunburn and intermittent sun exposures are associated with increased melanoma risk, most studies have found null or inverse associations between occupational (more continuous pattern) sun exposure and melanoma risk....Our results suggest that occupational sun exposure does not increase risk of melanoma, even of melanomas situated on the head and neck. This finding seemed not to be due to negative confounding of occupational sun exposure by weekend sun."


A link to the research article is here.


Sun Avoidance Doubles Deaths

This study generated a lot of controversy, but mostly in people's desire to find a way to refute it when the results are quite clear. It looked at women in Sweden, and found that women who avoided the sun were twice as likely to die as those who got the most sun. In the sun avoiding group, 6% of the women died, versus 3% in those with the highest exposure to the sun.

"CONCLUSION: The results of this study provide observational evidence that avoiding sun exposure is a risk factor for all-cause mortality. Following sun exposure advice that is very restrictive in countries with low solar intensity might in fact be harmful to women's health."

A link to a summary article is here. A link to the research article is here.