Is sun exposure a major cause of melanoma? No

doi:10.1136/bmj.a764

Published 22 July 2008, doi:10.1136/bmj.a764
Cite this as: BMJ 2008;337:a764

Head to Head

Is sun exposure a major cause of melanoma? No

Sam Shuster, honorary consultant

¹ Department of Dermatology, Norfolk and Norwich University Hospital, Norwich NR4 7UY

sam@shuster.eclipse.co.uk

Every summer we are reminded about the dangers of the sun. ScottMenzies (doi: 10.1136/bmj.a763) argues that the risks of malignantmelanoma are real, but Sam Shuster is unconvinced

The first 150 words of the full text of this article appear below.

The list of harmful things grows daily, freshly mined by descriptiveepidemiology, a substitute for research that confuses associationwith cause. Although most disappear under the weight of theirown inconsequence, the alleged increase in melanoma from ultravioletradiation has survived on the life support of regular promotion.I am therefore setting out what is known, which is rather differentfrom what is believed.

There is solid descriptive, quantitative, and mechanistic proofthat ultraviolet rays cause the main skin cancers (basal andsquamous). They develop in pale, sun exposed skin,¹ are relatedto degree of exposure and latitude,² are fewer with avoidanceand protection,³ ⁴ are readily produced experimentally,⁴ andare the overwhelmingly predominant tumour in xeroderma pigmentosum,where DNA repair of ultraviolet light damage is impaired.

None of these is found with melanoma. Variation is more ethnic⁵⁶ ⁷ than pigmentary,⁸ and 75% occur on relatively unexposedsites,⁹ especially the feet of . . . [Full text of this article]

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This article has been cited by other articles:

Cooper, A. J (2008). Consequences of saying sun is not major cause of melanoma. BMJ 337: a1126-a1126 [Full text]
Quinton, R., Pearce, S. H S, Sievenpiper, J. L (2008). Time to go to get your hat. BMJ 337: a1130-a1130 [Full text]
Moncrieff, M. D, Garioch, J. (2008). Use your head and put a hat on it. BMJ 337: a1131-a1131 [Full text]
Burd, A. (2008). What about acral lentiginous melanoma?. BMJ 337: a1133-a1133 [Full text]

Rapid Responses:

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The consequences of the statement "Sun Exposure is not a major cause of Melanoma": Ashley J Cooper
bmj.com, 27 Jul 2008 [Full text]
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Re: melanoma: no fun in the sun: David G Tucker
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