Critique of the International Agency for Research on Cancer meta-analyses of the association of sunbed use with risk of cutaneous malignant melanoma

Figures & data

Figure 1 Plot of the relative risk for cutaneous melanoma versus mean latitude of those who first used sunbeds when younger than 35 years on the basis of data in Figure 2 of ref. 1. Data from the UK were not used in the regression analysis.

Table 1 Results of meta-analyses' calculations performed using various studies

Conditions	Ref. 1	OR, starting with original set in ref. 1	OR, starting with original set in ref. 1 plus ref. 22
Original set (refs. 2–21)	1.15 (95% CI, 1.00–1.30)	1.20 (95% CI, 1.03–1.38)	1.21 (95% CI, 1.05–1.39)
Original set less 2 UK studies (refs. 5, 14)		1.13 (95% CI, 0.99–1.29)	1.14 (95% CI, 1.00–1.30)
Original set less 5 UK (refs. 3, 5–7, 21)		1.09 (95% CI, 0.96–1.24)	1.10 (95% CI, 0.98–1.25)
Five UK studies (refs. 3, 5–7, 21)		2.09 (95% CI, 1.14–3.84)

Table 2 Melanoma incidence and mortality rates in the countries for which data were available for first use of sunbeds prior to age 35 years28

Country	Latitude (°N)	Males-I*	Males-M**	Females-I*	Females-M**	M Mo/I	F Mo/I
United States	39	17.2	2.6	12.1	1.3	0.15	0.11
Canada	46	9.1	2.1	8.2	1.2	0.23	0.15
France	48	6.6	1.6	11.2	1.3	0.24	0.12
Belgium	52	3.6	1.4	6.2	1.3	0.39	0.21
Netherlands	52.5	3.6	1.4	12.1	1.8	0.39	0.15
United Kingdom	53	7.5	2.0	9.3	1.5	0.27	0.16
Sweden	58	12.5	2.9	12.8	1.6	0.23	0.13
Norway	60	16.0	3.8	15.7	2.0	0.24	0.13

* cases/100,000/year;

** deaths/100,000/year;

F, female; I, incidence; M, male; Mo, mortality.

Table 3 Risk-modifying factors for CMM

Risk	Risk reduction	Reference
Skin type I	Skin type III, IV	3
UVA		26, 27, 32
Travel to sunny locations		33, 34
	UVB	36
	Vitamin D	37
High-fat diet	Fruits, vegetables	37
VDR	VDR	38
Sunburning		3, 39
	Melanogenesis	40
Gene present among Scots		29, 41
	Chronic solar UV irradiance	39, 42, 43
Sunscreen use		44
Skin aging, elastosis		45
	Smoking	46–48
Nevi		49

VDR, vitamin D receptor.

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