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Primary prevention of melanoma

Authors
Alan C Geller, RN, MPH
Susan Swetter, MD
Section Editors
Michael B Atkins, MD
Hensin Tsao, MD, PhD
Deputy Editor
Rosamaria Corona, MD, DSc

INTRODUCTION

Melanoma has become a worldwide public health concern [1-3]. At least two-thirds of melanoma in light-skinned populations worldwide may be attributed to ultraviolet (UV) radiation exposure from both natural and artificial sources [4]. Based upon this and other data implicating UV light as a risk factor for melanoma, reducing exposure to UV radiation has been advocated as a method to reduce the incidence of this malignancy [4,5]. The observed decline by approximately 5 percent per year in the incidence of invasive melanoma in the state of Queensland, Australia, among men and women aged 15 to 24 years in the period of 2006 through 2010 may be the result of sun awareness campaigns implemented in Australia on a national scale [6].  

Interventions that may be relevant to the primary prevention of melanoma will be reviewed here. Screening and risk factors for melanoma are discussed separately. (See "Screening and early detection of melanoma" and "Risk factors for the development of melanoma".)

ULTRAVIOLET RADIATION

Although a causal relationship between ultraviolet (UV) radiation and melanoma has not been directly demonstrated in humans, there is evidence in support of this relationship:

Epidemiologic studies have found that the risk of melanoma is higher among fair-skinned people [5]. In the United States, the incidence of melanoma is at least 20 times greater in whites than blacks, and the highest incidence of melanoma worldwide occurs in Queensland, Australia, a subtropical region with a predominantly Celtic population [7]. (See "Risk factors for the development of melanoma", section on 'Geographic and ethnic variation'.)

Among families predisposed to melanoma because of genetic mutations, the incidence of melanoma is 21-fold higher for individuals born after 1959 compared with those born before 1900, presumably due to an interaction between increased sun exposure and the predisposing gene mutation [8]. (See "Inherited susceptibility to melanoma".)

                  

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