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Risk factors in the causation of human malignant melanoma of the skin (western Australia) [microform]
Bib ID 3287479
Format MicroformMicroform, BookBook
Holman, C. D'Arcy J. (Cashel D'Arcy James), 1955-
Description 624 p. 

A case-control study of 511 cases of preinvasive and invasive melanoma, incident in Western Australia in 1980 and 1981, and 511 population-based controls, matched on age, sex and area of residence, is reported together with supporting investigations and a review of relevant literature. The results indicate major differences in aetiology between melanoma of different histogenetic types. Evidence is presented that Hutchinson's melanotic freckle type melanoma (HMF) has a direct dose-response relationship to ultra-violet radiation (UVR), except that at high doses there may be a modifying effect of cell sterilisation. HMF was also related to use of non-permanent hair dyes and occupational exposure to ionising radiation. Melanomas of the superficial spreading melanoma (SSM) type were associated with the presence of benign naevi, and with occasional as opposed to regular exposure to the sun, the relative protective effect of regular exposure being dependent on the ability to tan.

There was evidence that sun exposure in childhood and adolescence induced benign naevi, and that the number of naevi produced in early life may have a critical effect on later potential to develop SSM. There were also findings indicating a short-term stimulatory effect of sun exposure on junctional activity in benign naevi. Nodular melanoma (NM) shared several risk factors with both HMF and SSM and, in addition, was related to level of intake of certain meats, and possibly consumption of beer. Sunburn and exposure to ionising radiation were significant protective factors against NM. The relationship of unclassifiable melanoma (UCM) to sun exposure was weak; it may be associated with alcohol intake. The importance of pigmentary characteristics and other genetic influences on risk of all types of melanoma is confirmed. There was some evidence suggestive of a reduced melanoma risk in persons with high serum retinol concentrations.

Negative findings are reported in relation to use of the oral contraceptive pill, endogenous hormonal factors, polyunsaturated fats, lower limb depilation and a number of other agents which have been hypothesized as related to melanoma. It is proposed that two pathways exist for the development of the majority of melanomas. In the first, HMF results from an accumulation of radiation or chemical-damage to the melanocyte genome. In the second, initiated naevus cells arise either spontaneously or by the action of mutagenic agents including UVR, and then develop into SSM, and possibly some UCM, as a result of promotion by occasional sun exposure or other agents. NM is considered to be a common end-stage of these two pathways.



Source: Dissertation Abstracts International, Volume: 44-05, Section: B, page: 1420.

Thesis (Ph.D.)--University of Western Australia (Australia), 1983.

Reproduction Microfiche. Ann Arbor, Mich.: University Microfilms International. 
Subjects Health Sciences, Public Health.
Other authors/contributors University of Western Australia


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