Casey Crump1, Kristina Sundquist2, Weiva Sieh3, Marilyn A Winkleby3, Jan Sundquist2. 1. Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA kccrump@stanford.edu. 2. Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USADepartment of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA. 3. Department of Medicine, Stanford University, Stanford, CA, USA, Center for Primary Health Care Research, Lund University, Malmö, Sweden, Stanford Prevention Research Center, Stanford University, Stanford, CA, USA and Department of Health Research and Policy, Stanford University, Stanford, CA, USA.
Abstract
BACKGROUND: Ultraviolet radiation (UVR) exposure is the main risk factor for cutaneous malignant melanoma (CMM), but its specific effect in infancy is unknown. We examined whether season of birth, a proxy for solar UVR exposure in the first few months of life, is associated with CMM in childhood through young adulthood. METHODS: National cohort study of 3,571,574 persons born in Sweden in 1973-2008, followed up for CMM incidence through 2009 (maximum age 37 years) to examine season of birth and other perinatal factors. RESULTS: There were 1595 CMM cases in 63.9 million person-years of follow-up. We found a sinusoidal pattern in CMM risk by season of birth (P=0.006), with peak risk corresponding to birthdates in spring (March-May). Adjusted odds ratios for CMM by season of birth were 1.21 [95% confidence interval (CI), 1.05-1.39; P=0.008] for spring, 1.07 (95% CI, 0.92-1.24; P=0.40) for summer and 1.12 (95% CI, 0.96-1.29; P=0.14) for winter, relative to fall. Spring birth was associated with superficial spreading subtype of CMM (P=0.02), whereas there was no seasonal association with nodular subtype (P=0.26). Other CMM risk factors included family history of CMM in a sibling (>6-fold) or parent (>3-fold), female gender, high fetal growth and high paternal education level. CONCLUSIONS: In this large cohort study, persons born in spring had increased risk of CMM in childhood through young adulthood, suggesting that the first few months of life may be a critical period of UVR susceptibility. Sun avoidance in early infancy may play an important role in the prevention of CMM in high-risk populations.
BACKGROUND: Ultraviolet radiation (UVR) exposure is the main risk factor for cutaneous malignant melanoma (CMM), but its specific effect in infancy is unknown. We examined whether season of birth, a proxy for solar UVR exposure in the first few months of life, is associated with CMM in childhood through young adulthood. METHODS: National cohort study of 3,571,574 persons born in Sweden in 1973-2008, followed up for CMM incidence through 2009 (maximum age 37 years) to examine season of birth and other perinatal factors. RESULTS: There were 1595 CMM cases in 63.9 million person-years of follow-up. We found a sinusoidal pattern in CMM risk by season of birth (P=0.006), with peak risk corresponding to birthdates in spring (March-May). Adjusted odds ratios for CMM by season of birth were 1.21 [95% confidence interval (CI), 1.05-1.39; P=0.008] for spring, 1.07 (95% CI, 0.92-1.24; P=0.40) for summer and 1.12 (95% CI, 0.96-1.29; P=0.14) for winter, relative to fall. Spring birth was associated with superficial spreading subtype of CMM (P=0.02), whereas there was no seasonal association with nodular subtype (P=0.26). Other CMM risk factors included family history of CMM in a sibling (>6-fold) or parent (>3-fold), female gender, high fetal growth and high paternal education level. CONCLUSIONS: In this large cohort study, persons born in spring had increased risk of CMM in childhood through young adulthood, suggesting that the first few months of life may be a critical period of UVR susceptibility. Sun avoidance in early infancy may play an important role in the prevention of CMM in high-risk populations.
Authors: K J Johnson; S E Carozza; E J Chow; E E Fox; S Horel; C C McLaughlin; B A Mueller; S E Puumala; P Reynolds; J Von Behren; L G Spector Journal: Br J Cancer Date: 2011-09-13 Impact factor: 7.640
Authors: Katherine Y Wojcik; Loraine A Escobedo; Ashley Wysong; Julia E Heck; Beate Ritz; Ann S Hamilton; Joel Milam; Myles G Cockburn Journal: Epidemiology Date: 2019-03 Impact factor: 4.860