Autier P, Doré J F, Gefeller O, Cesarini J P, Lejeune F, Koelmel K F, Lienard D, Kleeberg U R
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
Br J Cancer. 1997;76(11):1521-4. doi: 10.1038/bjc.1997.588.
Melanoma risk among subjects from Germany, France and Belgium who had lived for 1 year or more in sunny climates was examined in a one-to-one unmatched case-control study conducted among white subjects 20 years old or more. A total of 412 consecutive patients with melanoma diagnosed from 1 January 1991 onwards, were derived from hospital registers; 445 controls were randomly chosen in the same municipality as the cases. After adjustment for host characteristics, melanoma risk associated with residence in a sunny area was 2.7 (95% CI: 1.4-5.2), increasing to 4.7 (95% CI: 1.4-13.5) if subjects sought a suntan when residing in sunny climates, and to 4.3 (95% CI: 1.7-11.1) if subjects arrived before the age of 10 years in the sunny area. Residence in sunny areas and recreational sun exposure seemed to combine their effects on melanoma risk. Increase in melanoma risk conveyed by deliberate sun exposure during adulthood was highest among subjects who had lived in sunny areas as a child or adolescent and lowest among subjects who had never resided in sunny areas. Our results support conclusions from migrant studies that indicated that childhood is a critical period of either vulnerability to solar radiation or more frequent exposures to melanoma risk factors. They also suggest that moderate sun exposure of an adult who was heavily sun exposed in childhood is associated with a higher melanoma risk than that of high sun exposure of an adult who was sun protected in childhood.
在一项针对20岁及以上白人受试者开展的一对一非匹配病例对照研究中,对来自德国、法国和比利时且在阳光充足地区居住过1年或更长时间的受试者的黑色素瘤风险进行了检测。共有412例自1991年1月1日起确诊的黑色素瘤连续患者,来源于医院登记记录;445名对照在与病例相同的城市中随机选取。在对宿主特征进行调整后,居住在阳光充足地区相关的黑色素瘤风险为2.7(95%置信区间:1.4 - 5.2),如果受试者在阳光充足地区居住时寻求晒黑,风险增至4.7(95%置信区间:1.4 - 13.5),如果受试者在10岁之前到达阳光充足地区,风险则为4.3(95%置信区间:1.7 - 11.1)。居住在阳光充足地区和进行休闲日光暴露似乎会共同影响黑色素瘤风险。成年期故意日光暴露所带来的黑色素瘤风险增加,在儿童或青少年时期居住在阳光充足地区的受试者中最高,而在从未居住在阳光充足地区的受试者中最低。我们的结果支持了移民研究的结论,即童年是对太阳辐射易感性增加或更频繁接触黑色素瘤风险因素的关键时期。它们还表明,童年时期大量暴露于阳光下的成年人适度日光暴露,比童年时期受到防晒保护的成年人大量日光暴露,与更高的黑色素瘤风险相关。