Melanoma and the Sun: The Effect of Swimsuits and a “Healthy” Tan on the Risk of Nonfamilial Malignant Melanoma in Women

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Abstract
The authors examined the relation between sun exposure and melanoma risk and tested the previously published site-specific association of bikini use and melanoma of the trunk in a study of 130 cases incident between 1976 and 1984 and 300 controls nested within the Nurses' Health Study. A summary variable derived from four measures of sun sensitivity was more closely associated with melanoma than any component measure. There was no association of bikini use at ages 15–20 years with trunk melanoma risk (relative risk (RR) = 0.8, p = 0.7), and the 95% confidence interval (Cl) (0.3–2.6) excludes the previously published estimate. High frequency of swimsuit use outdoors at ages 15–20 years was associated with increased melanoma risk among sun-sensitive women (RR = 6.4, 95% Cl 1.7–23.8, p = 0.006), but appeared to be protective among sun-resistant women (RR = 0.3, 95% Cl 0.1–1.0, p = 0.06). These findings suggest that the risk of trunk melanoma associated with bikini use is at most modest and that sun-sensitive women may increase their risk of melanoma with frequent sun exposures, but that sun-resistant women do not, presumably because they develop a photoprotective tan.

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