MELANOMA AND SUNBURN

A computer-aided search identified 16 case-control studies which speci fically assessed sunburn as a risk factor for cutaneous malignant mela noma. Using unadjusted estimates, a history of sunburn was associated with significantly increased risk of melanoma in all but one study. Fo ur studies were defined as core studies after assessment of study qual ity; however, only two of these had sufficiently similar definitions o f sunburn to allow pooling of results. Using pooled data, the risk of melanoma in those ever sunburned was 2.0 (95 percent confidence interv al [CI] = 1.6-2.6), while the highest category of sunburn exposure had a risk of 3.7 (CI = 2.5-5.4). The suggestion that sunburns in childho od carry greater risk of melanoma cannot be supported by pooled analys is. This review demonstrated considerable variation in design and meth od among the studies, and identified sources of bias which prevented a pooled analysis using all available data. The need for strong epidemi ologic evidence relating sunburn to melanoma, particularly in childhoo d, is of prime importance, since avoidance of sunburn is one of the fe w potential means of primary prevention of melanoma.