EPIDEMIOLOGICAL 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