Nevus density and melanoma risk in women: A pooled analysis to test the divergent pathway hypothesis

Olsen, Catherine M., Zens, Michael S., Stukel, Therese A., Sacerdote, Carlotta, Chang, Yu-Mei, Armstrong, Bruce K., Bataille, Veronique, Berwick, Marianne, Elwood, J. Mark, Holly, Elizabeth A., Kirkpatrick, Connie, Mack, Thomas, Bishop, Julia Newton, Osterlind, Anne, Swerdlow, Anthony J., Zanetti, Roberto, Green, Adele C., Karagas, Margaret R. and Whiteman, David C. (2009) Nevus density and melanoma risk in women: A pooled analysis to test the divergent pathway hypothesis. International Journal of Cancer, 124 4: 937-944. doi:10.1002/ijc.24011

Author Olsen, Catherine M.
Zens, Michael S.
Stukel, Therese A.
Sacerdote, Carlotta
Chang, Yu-Mei
Armstrong, Bruce K.
Bataille, Veronique
Berwick, Marianne
Elwood, J. Mark
Holly, Elizabeth A.
Kirkpatrick, Connie
Mack, Thomas
Bishop, Julia Newton
Osterlind, Anne
Swerdlow, Anthony J.
Zanetti, Roberto
Green, Adele C.
Karagas, Margaret R.
Whiteman, David C.
Title Nevus density and melanoma risk in women: A pooled analysis to test the divergent pathway hypothesis
Journal name International Journal of Cancer   Check publisher's open access policy
ISSN 0020-7136
Publication date 2009-02-15
Year available 2008
Sub-type Article (original research)
DOI 10.1002/ijc.24011
Volume 124
Issue 4
Start page 937
End page 944
Total pages 8
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract
A “divergent pathway” model for the development of cutaneous melanoma has been proposed. The model hypothesizes that melanomas occurring in people with a low tendency to develop nevi will, on average, arise more commonly on habitually sun-exposed body sites such as the head and neck. In contrast, people with an inherent propensity to develop nevi will tend to develop melanomas most often on body sites with large melanocyte populations, such as on the back. We conducted a collaborative analysis to test this hypothesis using the original data from 10 case–control studies of melanoma in women (2,406 cases and 3,119 controls), with assessment of the potential confounding effects of socioeconomic, pigmentary and sun exposure-related factors. Higher nevus count on the arm was associated specifically with an increased risk of melanoma of the trunk (p for trend = 0.0004) and limbs (both upper and lower limb p for trends = 0.01), but not of the head and neck (p for trend = 0.25). The pooled odds ratios for the highest quartile of nonzero nevus count versus none were 4.6 (95% confidence interval (CI) 2.7–7.6) for melanoma of the trunk, 2.0 (95% CI 0.9–4.5) for the head and neck, 4.2 (95% CI 2.3–7.5) for the upper limbs and 3.4 (95% CI 1.5–7.9) for the lower limbs. Aggregate data from these studies suggest that high nevus counts are strongly associated with melanoma of the trunk but less so if at all of the head and neck. This finding supports different etiologic pathways of melanoma development by anatomic site.
Keyword Melanoma
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Article first published online: 19 SEP 2008

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 34 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 03 Sep 2009, 09:00:39 EST by Mr Andrew Martlew on behalf of School of Public Health