10.3 Risk factors

Table 10.2 Risk factors for melanoma of the skin, by direction of association and strength of evidence


Increases risk

Decreases risk

Convincing or probable

Sun exposure (mainly recreational)1-3


Sunbed/sunlamp use4


History of sunburn1-3,5


Presence of benign sun damage in the skin2,5


Number of naevi2,6,7


Density of freckles or freckling as a child2,8


Skin, hair and eye colour1,2,8,9


Ability to tan2


Family history of melanoma8,10,11


High socio-economic status12


Body fatness and weight gain in adulthood13,14

1 International Agency for Research on Cancer, 2001; 2 Armstrong and Kricker, 2001; 3 Gandini et al., 2005a; 4 El Ghissasi et al., 2009; 5 Olsen et al., 2011; 6 risk raised for high numbers of either common or atypical naevi or both; 7 Olsen et al., 2010b;

8 Gandini et al., 2005b; 9 Olsen et al., 2010b; 10 Olsen et al., 2010c; 11 melanoma in one or more first degree relatives; 12 Faggiano et al., 1997; 13 Olsen et al., 2008; 14 Renehan et al., 2008

Exposure to ultraviolet (UV) radiation, the primary source of which is sunlight, is the main cause of melanoma of the skin (Table 10.2). Risk increases with increasing levels of intermittent, or recreational, sun exposure. A history of sunburn, often considered to be a marker of high levels of intermittent sun exposure, is associated with raised risk in a dose-response fashion. Presence of benign sun damage (solar keratoses) is a marker of increased risk, particularly for melanomas on the head and neck. Exposure to artificial UV radiation, through use of sunbeds or sunlamps, also causes melanoma. Constitutional factors act together with UV exposure to influence the chance of an individual developing melanoma. Risk is increased in those with more naevi (moles), a high density of freckles (or who had freckling as a child), light hair, skin or eye colour, and less ability to tan.

Melanoma risk is higher in those of higher socio-economic status. This may be due to greater recreational sun exposure among more affluent groups.

Individuals with one or more first degree relatives who have had melanoma have a two-fold increased risk of developing it themselves. On average, around 4% of cases of melanoma are estimated to be attributable to familial risk.

In terms of more tentative associations, modest positive relationships have been reported between melanoma risk and higher body mass index in men and weight gain in adulthood in women. 

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