The Association Between Naevi and Melanoma in Populations with Different Levels of Sun Exposure: a Joint Case-control Study of Melanoma in the UK and Australia

Overview

Journal Br J Cancer

Specialty Oncology

Date 1998 Feb 24

PMID 9472652

Citations 23

Authors

V Bataille

A Grulich

P Sasieni

A Swerdlow

J Newton Bishop

W McCarthy

P Hersey

J Cuzick

Affiliations

Soon will be listed here.

Abstract

Two case-control studies were set up to investigate the relationship between melanocytic naevi and risk of melanoma and to compare the naevus phenotype in two countries exposed to greatly different levels of sun exposure and different melanoma rates. In England 117 melanoma cases and 163 controls were recruited from the North-East Thames Region and 183 melanoma cases and 162 controls from New South Wales, Australia. Each subject underwent a whole-body naevus count performed by the same examiner in each country. Relative risks associated with melanocytic naevi in each country were calculated with comparison of naevus data in controls between Australia and England. Atypical naevi were strong risk factors for melanoma in both countries: the odds ratio (OR) for three or more atypical naevi was 4.6 (95% CI 2.0-10.7) in Australia compared with 51.7 (95% CI 6.5-408.4) in England. Common naevi were also significant risk factors in Australia and England with similar odds ratios in the two countries. Prevalence of atypical naevi was greater in Australian controls than in English controls: OR 9.7 (95% CI 1.2-81.7) for three or more atypical naevi in Australia compared with England. For young age groups, the median number of common naevi was greater in Australia than in the UK, whereas for older individuals this difference in naevi number between the two countries disappeared. The prevalence of naevi on non-sun-exposed sites in controls was not significantly different between the two countries. The atypical mole syndrome (AMS) phenotype was more prevalent in Australian controls (6%) than in English controls (2%). The results of this study support the role of sun exposure in the induction of atypical naevi in adults. There was a trend towards stronger risk factors associated with atypical naevi in England compared with Australia. The atypical mole syndrome, usually associated with a genetic susceptibility to melanoma, was more common in Australia than in England, suggesting genetic environmental interactions with the possibility of phenocopies induced by sunlight.

Citing Articles

The Importance of Early Detection and Prevention of Atypical Skin Lesions and Other Melanoma Risk Factors in a Younger Population.

Karp P, Karp K, Kadziela M, Zajdel R, Zebrowska A Cancers (Basel). 2025; 16(24.

PMID: 39766163 PMC: 11674410. DOI: 10.3390/cancers16244264.

Sun-Protective Clothing Worn Regularly during Early Childhood Reduces the Number of New Melanocytic Nevi: The North Queensland Sun-Safe Clothing Cluster Randomized Controlled Trial.

Harrison S, Buettner P, Nowak M Cancers (Basel). 2023; 15(6).

PMID: 36980647 PMC: 10046807. DOI: 10.3390/cancers15061762.

Differences in Melanoma Between Canada and New South Wales, Australia: A Population-Based Genes, Environment, and Melanoma (GEM) Study.

Yardman-Frank J, Glassheim E, Kricker A, Armstrong B, Marrett L, Luo L JID Innov. 2021; 1(1).

PMID: 33768212 PMC: 7990302. DOI: 10.1016/j.xjidi.2021.100002.

Associations of pigmentary and naevus phenotype with melanoma risk in two populations with comparable ancestry but contrasting levels of ambient sun exposure.

Cust A, Drummond M, Bishop D, Azizi L, Schmid H, Jenkins M J Eur Acad Dermatol Venereol. 2019; 33(10):1874-1885.

PMID: 31087403 PMC: 6800761. DOI: 10.1111/jdv.15680.

Novel pleiotropic risk loci for melanoma and nevus density implicate multiple biological pathways.

Duffy D, Zhu G, Li X, Sanna M, Iles M, Jacobs L Nat Commun. 2018; 9(1):4774.

PMID: 30429480 PMC: 6235897. DOI: 10.1038/s41467-018-06649-5.

References

Nicholls E . Development and elimination of pigmented moles, and the anatomical distribution of primary malignant melanoma. Cancer. 1973; 32(1):191-5. DOI: 10.1002/1097-0142(197307)32:1<191::aid-cncr2820320129>3.0.co;2-w. View

Grulich A, Bataille V, Swerdlow A, Newton-Bishop J, Cuzick J, Hersey P . Naevi and pigmentary characteristics as risk factors for melanoma in a high-risk population: a case-control study in New South Wales, Australia. Int J Cancer. 1996; 67(4):485-91. DOI: 10.1002/(SICI)1097-0215(19960807)67:4<485::AID-IJC4>3.0.CO;2-O. View

Holman C, Armstrong B . Pigmentary traits, ethnic origin, benign nevi, and family history as risk factors for cutaneous malignant melanoma. J Natl Cancer Inst. 1984; 72(2):257-66. View

Holman C, Armstrong B . Cutaneous malignant melanoma and indicators of total accumulated exposure to the sun: an analysis separating histogenetic types. J Natl Cancer Inst. 1984; 73(1):75-82. View

Greene M, Clark Jr W, Tucker M, Kraemer K, Elder D, Fraser M . High risk of malignant melanoma in melanoma-prone families with dysplastic nevi. Ann Intern Med. 1985; 102(4):458-65. DOI: 10.7326/0003-4819-102-4-458. View

Cooke K, SPEARS G, Skegg D . Frequency of moles in a defined population. J Epidemiol Community Health. 1985; 39(1):48-52. PMC: 1052400. DOI: 10.1136/jech.39.1.48. View

Mackie R, English J, Aitchison T, Fitzsimons C, Wilson P . The number and distribution of benign pigmented moles (melanocytic naevi) in a healthy British population. Br J Dermatol. 1985; 113(2):167-74. DOI: 10.1111/j.1365-2133.1985.tb02060.x. View

Swerdlow A, English J, Mackie R, ODoherty C, Hunter J, Clark J . Benign melanocytic naevi as a risk factor for malignant melanoma. Br Med J (Clin Res Ed). 1986; 292(6535):1555-9. PMC: 1340558. DOI: 10.1136/bmj.292.6535.1555. View

Armstrong B, de Klerk N, Holman C . Etiology of common acquired melanocytic nevi: constitutional variables, sun exposure, and diet. J Natl Cancer Inst. 1986; 77(2):329-35. View

10.

Green A, Bain C, McLennan R, Siskind V . Risk factors for cutaneous melanoma in Queensland. Recent Results Cancer Res. 1986; 102:76-97. DOI: 10.1007/978-3-642-82641-2_6. View

11.

Holly E, Kelly J, Shpall S, Chiu S . Number of melanocytic nevi as a major risk factor for malignant melanoma. J Am Acad Dermatol. 1987; 17(3):459-68. DOI: 10.1016/s0190-9622(87)70230-8. View

12.

Greenland S . Variance estimators for attributable fraction estimates consistent in both large strata and sparse data. Stat Med. 1987; 6(6):701-8. DOI: 10.1002/sim.4780060607. View

13.

Osterlind A, Tucker M, HOU-JENSEN K, Stone B, Engholm G, JENSEN O . The Danish case-control study of cutaneous malignant melanoma. I. Importance of host factors. Int J Cancer. 1988; 42(2):200-6. DOI: 10.1002/ijc.2910420210. View

14.

Sigg C, Pelloni F . Frequency of acquired melanonevocytic nevi and their relationship to skin complexion in 939 schoolchildren. Dermatologica. 1989; 179(3):123-8. DOI: 10.1159/000248337. View

15.

Gallagher R, McLean D, Yang C, Coldman A, SILVER H, Spinelli J . Suntan, sunburn, and pigmentation factors and the frequency of acquired melanocytic nevi in children. Similarities to melanoma: the Vancouver Mole Study. Arch Dermatol. 1990; 126(6):770-6. View

16.

Grob J, Gouvernet J, Aymar D, Mostaque A, Romano M, Collet A . Count of benign melanocytic nevi as a major indicator of risk for nonfamilial nodular and superficial spreading melanoma. Cancer. 1990; 66(2):387-95. DOI: 10.1002/1097-0142(19900715)66:2<387::aid-cncr2820660232>3.0.co;2-j. View

17.

Easton D, Cox G, MacDonald A, Ponder B . Genetic susceptibility to naevi--a twin study. Br J Cancer. 1991; 64(6):1164-7. PMC: 1977833. DOI: 10.1038/bjc.1991.483. View

18.

Augustsson A, Stierner U, Rosdahl I, Suurkula M . Common and dysplastic naevi as risk factors for cutaneous malignant melanoma in a Swedish population. Acta Derm Venereol. 1991; 71(6):518-24. View

19.

MACLENNAN R, Green A, McLeod G, Martin N . Increasing incidence of cutaneous melanoma in Queensland, Australia. J Natl Cancer Inst. 1992; 84(18):1427-32. DOI: 10.1093/jnci/84.18.1427. View

20.

Cannon-Albright L, Goldgar D, Meyer L, Lewis C, Anderson D, Fountain J . Assignment of a locus for familial melanoma, MLM, to chromosome 9p13-p22. Science. 1992; 258(5085):1148-52. DOI: 10.1126/science.1439824. View