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Occupation and the risk of malignant melanoma

Pion IA; Rigel DS; Garfinkel L; Silverman MK; Kopf AW
BACKGROUND. The incidence of malignant melanoma is increasing rapidly. The risk for development of malignant melanoma has been reported to be higher in persons of higher socioeconomic status. METHODS. This case-control study explores the relation between occupation and malignant melanoma relative risk through analysis of data collected by the American Cancer Society. A total of 1.2 million people were enrolled in a study of lifestyles and environmental factors in relation to mortality from cancer and other diseases. A total of 2780 persons had a history of malignant melanoma when the study began or developed malignant melanoma during the 6-year study follow-up period. The controls were matched for age, sex, race, and geographic location on an approximately 1:3 basis to persons selected from the remaining people enrolled. RESULTS. In men, malignant melanoma risk was significantly higher in high-paying versus low-paying occupations (odds ratio [OR], = 1.58; P < 0.001) and in white-collar versus blue-collar occupations (OR = 1.33; P < 0.001). No significant conclusions could be drawn for women. No significant difference in risk was noted between those with indoor versus outdoor occupations. Among specific occupational exposures, only exposure to X-rays significantly raised malignant melanoma risk (OR = 1.37; P = 0.002). CONCLUSION. Upper pay scale and white-collar occupations significantly increase the risk for development of malignant melanoma
PMID: 7804988
ISSN: 0008-543x
CID: 6715

Basal cell and squamous cell carcinomas are important risk factors for cutaneous malignant melanoma. Screening implications

Marghoob AA; Slade J; Salopek TG; Kopf AW; Bart RS; Rigel DS
BACKGROUND. This study was designed to determine the risk of developing malignant melanoma (MM) in patients with a history of basal cell and/or squamous cell skin cancer (BCC/SCC) and to determine whether surveillance efforts can be directed toward these patients for the detection of early MMs. METHODS. The study cohort was followed by annual total cutaneous examination (TCE). Controls consisted of individuals from the United States population matched for age, sex, and length of follow-up. The anatomic locations of the study cohorts' newly diagnosed MMs were plotted on an anatomic chart. The setting was a private dermatology practice. Two hundred, ninety consecutive white patients with a history of BCC/SCC but with no personal or family history of MM were followed by annual TCEs. The main outcome measures were the relative risk of developing MM and their prognosis. RESULTS. Ten of the 290 patients developed an MM within an average of 109 months of follow-up (range, 3-17 years). All MMs were less than 0.70 mm in Breslow thickness and 80% occurred on usually clothed cutaneous sites. The expected number of MMs in the control population was 0.59 (P = 0.006), resulting in a relative risk of 17. CONCLUSION. Patients with BCC/SCC skin cancer are at substantial increased risk for developing MM. Regular and life-long surveillance TCE is an inexpensive and effective method for detecting curable MMs in such patients
PMID: 7804999
ISSN: 0008-543x
CID: 12815

Identification of those at highest risk for development of malignant melanoma

Rigel DS
Multiple factors have been identified to be associated with increasing risk for MM developing. These factors are summarized in Table 2. As the incidence of MM continues to rise and the magnitude of this problem becomes more significant, the issue of identifying those at increased risk for MM developing in the future will become even more important
PMID: 7794670
ISSN: 0882-0880
CID: 6862

Risk of developing cutaneous malignant melanoma in atypical-mole syndrome: New York University experience and literature review

Slade J; Salopek TG; Marghoob AA; Kopf AW; Rigel DS
The presence of atypical moles (AM) is considered to be a marker for an increased risk of developing cutaneous malignant melanoma (MM). The extent to which individuals with the atypical-mole syndrome (AMS) are at risk for developing MM is unknown. We present a review of the world literature and of our experience at New York University. We conclude that the presence of AMS in Caucasians significantly increases the risk of developing MM, regardless of geographic location. A further increase in MM risk is noted if there is a personal and/or family history of MM
PMID: 7597314
ISSN: 0080-0015
CID: 12841

Risk of cutaneous malignant melanoma in patients with 'classic' atypical-mole syndrome. A case-control study

Marghoob AA; Kopf AW; Rigel DS; Bart RS; Friedman RJ; Yadav S; Abadir M; Sanfilippo L; Silverman MK; Vossaert KA
BACKGROUND AND DESIGN: There is an increased risk of developing cutaneous malignant melanomas (MMs) in patients with classic atypical-mole syndrome (AMS). This study compares the incidence of newly diagnosed MMs in patients with classic AMS (cases) with the incidence of newly diagnosed MMs developing in a population without classic AMS (control patients). The charts of 287 white patients with AMS and 831 white patients without AMS were reviewed for the occurrence of newly diagnosed invasive MMs during follow-up. Both cases and control patients were followed up regularly by total-body cutaneous examinations. The cumulative 10-year risk for developing newly diagnosed invasive MMs was calculated (life-table method) for each cohort. RESULTS: Of the 287 AMS cases, 10 developed a newly diagnosed invasive MM, resulting in a 10-year cumulative risk of 10.7%. Of the 831 control patients, two developed a newly diagnosed invasive MM, resulting in a 10-year cumulative risk of 0.62%. CONCLUSION: Patients with classic AMS, regardless of the presence of a personal and/or family history of MM, are at significantly increased risk of developing invasive MMs compared with control patients
PMID: 8053716
ISSN: 0003-987x
CID: 8191

Lack of selective attendance of participants at skin cancer/melanoma screening clinics [Comment]

Rigel DS; Friedman RJ
PMID: 8021360
ISSN: 0190-9622
CID: 16829

Risk of malignant melanoma for patients with "classic" atypical-mole syndrome

Marghoob AA; Kopf AW; Rigel DS; Bart RS; Friedman RJ; Yadav S; Abadir M; Sanfilippo L; Silverman MK; Vossaert KA
ORIGINAL:0005526
ISSN: n/a
CID: 62437

The rationale of the ABCDs of early melanoma [Comment]

Rigel DS; Friedman RJ
PMID: 8245255
ISSN: 0190-9622
CID: 16830

Lesion thickness and prognosis in melanoma: horses are not zebras. A response to Green and Ackerman

Rigel DS; Kopf AW; Friedman RJ
PMID: 8238784
ISSN: 0193-1091
CID: 6496

The gender-related issues in malignant melanoma

Rigel DS
The problem of malignant melanoma is important in the United States, in the world as a whole, and particularly in Hawaii with its high levels of ultraviolet radiation. It is estimated that 32,000 Americans will develop melanoma and 6,800 will die of this tumor in 1993. Melanoma is now the seventh most frequent cancer in the United States. It is more common than ovarian, cervical, CNS cancer and leukemia. Both incidence and mortality from melanoma are rapidly increasing. The incidence of melanoma has consistently increased 6% a year and the death rate has increased 2% a year since 1950. At current rates, one in 400 will die of this tumor. Should this rate of increase continue, by the year 2000, it is estimated that one in 75 Americans will develop melanoma during a lifetime. The highest melanoma incidence in the U.S. is found in Hawaii. Melanoma is increasing faster than any other cancer in the United States and all over the world
PMID: 8320089
ISSN: 0017-8594
CID: 13182