Epidemiological Aspects Of Cutaneous Malignant Melanoma

Significant progress has been made in recent years in understanding the origins of cutaneous maligant melanoma. Knowledge of the relationship between solar radiation and melanoma has changed and it now appears that both the character and timing of exposure may be more important than total cumulative dose in accounting for risk. The melanoma-sunlight model may prove an instructive heuristic exercise for environmental epidemiology, as we currently tend to restrict ourselves to a search for uniform total dose--response relationships between cancers and suspected environmental carcinogens. The study of the relationship between acquired melanocytic nevi and melanoma has led to useful new information about predictors of melanoma risk, and in addition has opened new perspectives on the development of nevi in children. Definition of the factors for nevus development in children may lead to the possibility of primary prevention programs for melanoma in younger generations of children. Recent new evidence suggests that certain occupational groups may be at elevated risk of melanoma. A great deal of work is going into the study of ways of screening high risk populations in order to detect melanoma at its earliest stages when current treatment protocols are most effective. The visibility of lesions on the skin challenges classical definitions of early detection and screening in epidemiology.

Interest in the etiology of malignant melanoma has increased enor mously in the last 10 years, after it was realized that the incidence of the cutaneous form of the disease was rising. Treatment of the disease has not improved dramatically, and our best hope for curtailing the rise in mortality and morbidity from the disease appears to be primarily through early detection and, per haps in the future, through prevention. It is thus very important for the medical community to be able to recognize individuals and groups at high risk of the disease because of either familial and con stitutional factors and lifestyle or exposure to environmental risk factors. This book, arising from a meeting held in Vancouver in 1984, pro vides a summary of the latest findings amo ~ Caucasian popula tions along with perspectives on the most im, Jrtant environmental risk factors identified to date. Comparison of results from the four major analytic studies presented here also demonstrates that a num ber of factors implicated in other common cancers are probably not related to the incidence of melanoma. These include smoking, alco hol consumption, and for the most part, diet. The Vancouver conference was sponsored by the Cancer Control Agency of British Columbia, and was financially supported by Health and Welfare Canada (6610-1429-50), the Northern Califor nia Cancer Program (NCCP), Miles Laboratories (Canada), Bristol Myers Laboratories (Canada), and Plough Canada Inc.

Written by the leading melanoma experts from the United States, Australia, and Europe, this new edition incorporates the clinical outcomes of more than 70,000 patients treated at major melanoma centers throughout the world and is the definitive and most authoritative textbook on melanoma used worldwide. Providing the most up-to-date and comprehensive information needed for the clinical management and scientific study of melanoma, Cutaneous Melanoma, 6th edition covers everything from precursors of melanoma to advanced stages of metastatic disease.

The third edition is a comprehensive and updated overview of positive and negative effects of UV-exposure, with a focus on Vitamin D and skin cancer. Researchers, oncologists,and students will be provided with the most significant and timely information related to topics such as the epidemiology of skin cancer, the immune system and skin cancer, ultraviolet damage, DNA repair and Vitamin D in Nonmelanoma skin cancer and malignant melanoma. There have been a number of new, scientific findings in this fast moving field that necessitated a thoroughly updated and revised edition including new Vitamin D metabolites and skin cancer, new findings on the beneficial effects of UV and solar UV and skin cancer, adverse effects of sun protection and sunscreens, sun exposure and mortality, and more. The book will summarize essential, up-to-date information for every clinician or scientist interested in how to balance the positive and negative effects of UV‐exposure to minimize the risks of developing vitamin D deficiency and skin cancer.