Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, PO Box 1122 Blindern, N-0317 Oslo, Norway.
Cancer Epidemiol Biomarkers Prev. 2010 Jan;19(1):111-20. doi: 10.1158/1055-9965.EPI-09-0567.
Few prospective studies have analyzed solar and artificial (solarium) UV exposure and melanoma risk. We investigated these associations in a Norwegian-Swedish cohort study and addressed effect modification by age, pigmentary characteristics, and nevi.
The cohort included women ages 30 to 50 years at enrollment from 1991 to 1992. Host factors and exposure to sun and solariums in life decades were collected by questionnaire at enrollment. Relative risks (RR) with 95% confidence intervals (CI) were estimated by Poisson regression.
Among 106,366 women with complete follow-up through 2005, 412 melanoma cases were diagnosed. Hair color and large, asymmetric nevi on the legs were strongly associated with melanoma risk (P(trend) < 0.001), and the RR for > or =2 nevi increased from brown/black to blond/yellow to red-haired women (RRs, 1.72, 3.30, and 4.95, respectively; P(interaction) = 0.18). Melanoma risk increased significantly with the number of sunburns and bathing vacations in the first three age decades (P(trend) < or = 0.04) and solarium use at ages 30 to 39 and 40 to 49 years [RRs for solarium use > or =1 time/mo 1.49 (95% CI, 1.11-2.00) and 1.61 (95% CI 1.10-2.35), respectively; P(trend) < or = 0.02]. Risk of melanoma associated with sunburns, bathing vacations, and solarium use increased with accumulating exposure across additional decades of life.
Melanoma risk seems to continue to increase with accumulating intermittent sun exposure and solarium use in early adulthood. Apparently, super-multiplicative joint effects of nevi and hair color identify people with red hair and multiple nevi as a very high risk group and suggest important gene-gene interactions involving MC1R in melanoma etiology.
很少有前瞻性研究分析过太阳和人工（日光浴）紫外线照射与黑色素瘤风险之间的关系。我们在一项挪威-瑞典队列研究中对此进行了调查，并探讨了年龄、色素特征和痣等因素对此关系的修饰作用。
该队列纳入了 1991 年至 1992 年入组时年龄在 30 至 50 岁之间的女性。在入组时通过问卷收集宿主因素和一生中太阳及日光浴暴露情况。采用泊松回归估计相对风险（RR）及其 95%置信区间（CI）。
在随访至 2005 年的 106366 名女性中，共诊断出 412 例黑色素瘤病例。头发颜色和腿部较大、不对称的痣与黑色素瘤风险显著相关（P(trend)<0.001），RR 随着头发颜色从棕色/黑色变为金发/黄色再变为红发而逐渐升高（RR 分别为 1.72、3.30 和 4.95；P(交互作用)=0.18）。黑色素瘤风险随着前三个年龄十年中晒伤和沐浴假期次数的增加而显著增加（P(trend)<0.04），并且在 30 至 39 岁和 40 至 49 岁时日光浴使用的风险也增加[RR 分别为日光浴使用>或=1 次/月 1.49（95%CI，1.11-2.00）和 1.61（95%CI，1.10-2.35）；P(trend)<0.02]。晒伤、沐浴假期和日光浴使用与黑色素瘤风险的关联随着一生中额外的数十年暴露而增加。
黑色素瘤风险似乎随着年轻时间歇性暴露于太阳和日光浴而持续增加。显然，痣和头发颜色的超多重联合作用确定红发和多个痣的人群为极高风险组，并提示 MC1R 基因在黑色素瘤病因学中存在重要的基因-基因相互作用。
