Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma.

The roles of constitutional factors and benign nevi in causation of malignant melanoma were examined in a case-control study of 511 patients and 511 matched controls in Western Australia. The strongest risk factor was the number of palpable benign nevi on a subject's arms. Compared to the risk of melanomas for persons having no palpable nevi on the arms, the relative risk of melanoma was 2.0 for persons with 1-4 nevi, 4.0 for persons with 5-9 nevi, and 11.3 for persons with 10 or more nevi (P less than .0001). Of the several pigmentary traits known to have associations with melanoma, inability to tan was the most important. Susceptibility to sunburn and hair color also had significant effects that were independent of tanning ability; however, after these traits were controlled, measured skin color and eye color had no additional effects. A reduced risk of melanoma was observed in persons having two or more Southern European grandparents [odds ratio (OR) = 0.39; P = .025]. Persons of Celtic origin did not have a significantly increased risk (OR = 1.18). Possession of one or more affected blood relatives was related to an increased risk of melanoma (OR = 2.69; P less than .0001). The effects of pigmentary traits, benign nevi, ethnic origin, and family history as risk factors were largely independent of one another.