Cancer Epidemiology and Services Research, Sydney School of Public Health, University of Sydney, NSW, Australia.
Int J Cancer. 2014 Jun 1;134(11):2735-41. doi: 10.1002/ijc.28603. Epub 2013 Nov 29.
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. The association of melanoma with occupational sun exposure may differ according to anatomical site, with some studies finding a positive association with melanoma on the head and neck. We examined the association between occupational sun exposure (self-reported weekday sun exposure) and melanoma risk according to anatomical site, using data from two multicentre population-based case-control studies: the Australian Melanoma Family Study (588 cases, 472 controls) and the Genes, Environment and Melanoma study (GEM; 1079 cases, 2,181 controls). Unconditional logistic regression was used to estimate odds ratios (OR) and their 95% confidence intervals, adjusting for potential confounders. Occupational sun exposure was not positively associated with melanoma risk overall or at different body sites in both studies. The GEM study found inverse associations between occupational sun exposure and melanoma on the head and neck [OR for highest vs. lowest quartile: 0.56, 95% confidence intervals (CI) 0.36-0.86, ptrend 0.02], and between the proportion of total sun exposure occurring on weekdays and melanoma on the upper limbs (OR for highest vs. lowest quartile: 0.66, 95% CI 0.42-1.02, ptrend 0.03). 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.
虽然晒伤和间歇性日晒与黑色素瘤风险增加有关，但大多数研究发现职业性（更连续的模式）日晒与黑色素瘤风险之间存在零关联或负相关。黑色素瘤与职业性日晒的关联可能因解剖部位而异，一些研究发现头部和颈部的黑色素瘤与职业性日晒呈正相关。我们利用来自两项多中心基于人群的病例对照研究的数据，根据解剖部位，检查了职业性日晒（自我报告的工作日日晒）与黑色素瘤风险之间的关联：澳大利亚黑色素瘤家族研究（588 例病例，472 例对照）和基因、环境与黑色素瘤研究（GEM；1079 例病例，2181 例对照）。采用非条件逻辑回归估计比值比（OR）及其 95%置信区间，并调整了潜在混杂因素。在这两项研究中，职业性日晒与整体黑色素瘤风险或不同身体部位的黑色素瘤风险均无正相关。GEM 研究发现职业性日晒与头部和颈部黑色素瘤之间呈负相关[最高与最低四分位数的比值比：0.56，95%置信区间（CI）0.36-0.86，ptrend0.02]，工作日总日晒量与上肢黑色素瘤之间也呈负相关（最高与最低四分位数的比值比：0.66，95%CI0.42-1.02，ptrend0.03）。我们的结果表明，职业性日晒不会增加黑色素瘤风险，即使是头部和颈部的黑色素瘤也是如此。这一发现似乎不是由于职业性日晒被周末日晒的负向混杂所导致。
