Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK.
Eur J Cancer. 2011 Mar;47(5):732-41. doi: 10.1016/j.ejca.2010.10.008.
A melanoma case-control study was conducted to elucidate the complex relationship between sun exposure and risk.
Nine hundred and sixty population-ascertained cases, 513 population and 174 sibling controls recruited in England provided detailed sun exposure and phenotype data; a subset provided serum 25-hydroxyvitamin D(2)+D(3) levels.
Phenotypes associated with a tendency to sunburn and reported sunburn at ≥ 20 years of age were associated with increased melanoma risk (odds ratio (OR) 1.56, 95% confidence intervals (CI) 1.23-1.99). Holiday sun exposure was not associated with an increased melanoma risk although this may be in part because reported sun exposure overall was much lower in those with a sun-sensitive phenotype, particularly among controls. Head and neck melanoma was associated with less sun exposure on holidays at low latitudes (OR 0.39, 95% CI (0.23-0.68) for >13 h/year compared to <3.1). Overall the clearest relationship between reported sun exposure and risk was for average weekend sun exposure in warmer months, which was protective (OR 0.67, 95% CI 0.50-0.89 for highest versus lowest tertile of exposure). Serum vitamin D levels were strongly associated with increased weekend and holiday sun exposure.
Sun-sensitive phenotypes and reported sunburn were associated with an increased risk of melanoma. Although no evidence was seen of a causal relationship between holiday sun exposure and increased risk, this is consistent with the view that intense sun exposure is causal for melanoma in those prone to sunburn. A protective effect of regular weekend sun exposure was seen, particularly for limb tumours, which could be mediated by photoadaptation or higher vitamin D levels.
进行了一项黑色素瘤病例对照研究，以阐明阳光暴露与风险之间的复杂关系。
在英国招募了 960 名人群确定的病例、513 名人群和 174 名同胞对照，提供了详细的阳光暴露和表型数据；一部分提供了血清 25-羟维生素 D(2)+D(3)水平。
与易晒伤和报告 20 岁以上晒伤相关的表型与黑色素瘤风险增加相关（比值比 (OR) 1.56，95%置信区间 (CI) 1.23-1.99）。假期阳光暴露与黑色素瘤风险增加无关，尽管这可能部分是因为具有阳光敏感表型的人报告的阳光暴露总体上要低得多，尤其是在对照组中。头颈部黑色素瘤与低纬度地区假期阳光暴露减少有关（与 <3.1 相比，每年 >13 小时/年的暴露，OR 0.39，95%CI（0.23-0.68））。总的来说，报告的阳光暴露与风险之间最清晰的关系是温暖月份周末的平均阳光暴露，这具有保护作用（暴露最高与最低三分位相比，OR 0.67，95%CI 0.50-0.89））。血清维生素 D 水平与周末和假期阳光暴露的增加密切相关。
阳光敏感表型和报告的晒伤与黑色素瘤风险增加相关。尽管没有证据表明假期阳光暴露与风险增加之间存在因果关系，但这与强烈阳光暴露对易晒伤人群的黑色素瘤具有因果关系的观点一致。定期周末阳光暴露具有保护作用，特别是对于肢体肿瘤，这可能是通过光适应或更高的维生素 D 水平介导的。
