BMJ 1995;311:749-750 (16 September)

Letters

Pathogenesis is multifactorial

EDITOR,--Johanna Adami and colleagues present evidence of an association between lymphoma and skin cancer, interpreting their findings as evidence of the role of immunosuppression induced by ultraviolet light in the pathogenesis of non-Hodgkin's lymphoma and leukaemia.1 There are, however, several reasons for believing that this conclusion may not be valid. According to the authors' line of reasoning, the incidence of lymphoma in countries where people are exposed to high doses of ultraviolet radiation should be considerably higher than that in countries with more temperate climates. Such a difference has never been reported. In contrast, the incidence of skin cancer in sunny countries is strictly related to exposure to ultraviolet radiation--for example, the incidence of malignant melanoma is 20.5/100000 person years in Hawaii compared with 8.8 in Detroit.2

Melanin in people with dark skin serves as a filter for ultraviolet radiation, and thus local and systemic effects of such radiation are . . . [Full text of this article]


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Relevant Article

Evidence of an association between non-Hodgkin's lymphoma and skin cancer
Johanna Adami, Morten Frisch, Jonathan Yuen, Bengt Glimelius, and Mads Melbye
BMJ 1995 310: 1491-1495. [Abstract] [Full Text]

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