UV radiation and cutaneous malignant melanoma : a meta-analysis of the existing literature
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Date
2025-06-13
Authors
Τσίτσιου, Σπυριδούλα-Ινώ
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Abstract
Cutaneous malignant melanoma is a highly aggressive type of skin cancer that develops in melanocytes, a type of cell located at the basal layer of the epidermis, that accumulates melanin to protect the surrounding tissues from the damaging effects of UV radiation. Exposure to UV light is the primary environmental factor associated with increased risk of melanoma development. This meta-analysis aimed to assess the risk effect of four types of UV exposure - intermittent, chronic, total sun exposure, and history of sunburn episodes – to the incidence of all prevalent histological subtypes of melanoma.
Twenty-six eligible retrospective case-control and prospective cohort studies were retrieved after MEDLINE search and screening, which produced twenty-two datasets for intermittent exposure, eleven for chronic, twelve for total exposure and twenty-two for sunburn history. Due to high heterogeneity between studies, a random-effects model was used for the meta-analysis. A statistically significant, positive correlation was identified between melanoma and each of the following: intermittent exposure (ln(RR): 0,29), total exposure (ln(RR): 0,51) or history of sunburn episodes (ln(RR): 0,52). Also, a positive correlation was identified between chronic exposure and melanoma (ln(RR): 0,51), yet it lacked statistical significance. Subgroup analysis revealed various factors that may have contributed to increased heterogeneity. The results on intermittent exposure were influenced by the period of publication and by the type of matching between cases and controls, while results on chronic exposure were affected by the percentage of melanoma cases with light hair color. These factors, along with the type of study resulted in high heterogeneity among datasets of total sun exposure, while the main factor that affected pooled effect estimates regarding sunburn history was the presence or absence of adjustment of the odds ratios to skin sensitivity. The combination of Egger’s and Begg’s tests suggested that these analyses were unaffected by publication bias.
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Keywords
Ultraviolet radiation, Cutaneous maignant melanoma, UV exposure, Sun exposure, Melanoma risk, Intermittent sun exposure