摘要:The purpose of this case-control study was to identify susceptible subgroups, primarily based on pigmentary characteristics, at higher risk of developing melanoma when exposed to the sun. The study group, which was interviewed from 1979 to 1982, consisted of 289 consecutive patients with melanoma and 527 randomly selected controls without cancer. In general, the risk of melanoma associated with sun exposure was greater for individuals expected to be susceptible on the basis of poor ability to tan, but not other pigmentary traits. There were, in addition, some noteworthy interactions between age and sun exposure. Among subjects with poor tanning ability, the risk of melanoma associated with outdoor occupation was more than 3-fold [odds ratio (OR) = 3.3] compared to indoor occupation. In contrast, the analogous OR was much less elevated among subjects with a good ability to tan (OR = 1.5). Mixed indoor and outdoor job exposure was protective among good tanners (OR = 0.80), but not among poor tanners (OR = 1.5). A similar pattern was seen for recreational sun exposure and, when applying multiple logistic regression, for the patient's overall subjective assessment of his lifetime sun exposure. However, quantitative assessment of average hours of sun exposure did not prove to be a good indicator of melanoma risk, even among susceptible individuals. A history of severe sunburn with blistering was associated with nearly 3-fold risk among poor tanners (OR = 2.9) but was protective among good tanners (OR = 0.79). A history of nonmelanoma skin cancer or solar keratosis was a very strong risk factor (OR = 7.3), which, however, did not significantly differ in magnitude among susceptibility subgroups. Full text Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References . 139 140 141 142 143 144 145 146 147 148 149 150 151