Head to Head

Is sun exposure a major cause of melanoma? Yes

BMJ 2008; 337 doi: 10.1136/bmj.a763 (Published 22 July 2008)
Cite this as: BMJ 2008;337:a763

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  1. Scott W Menzies, associate professor
  1. 1University of Sydney, Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Camperdown, 2050 NSW, Australia
  1. scott.menzies{at}email.cs.nsw.gov.au

    Every summer we are reminded about the dangers of the sun. Scott Menzies argues that the risks of malignant melanoma are real, but Sam Shuster (doi: 10.1136/bmj.a764) is unconvinced

    Although various phenotypic characteristics enhance or reduce the risk of developing melanoma, sun exposure is the main cause of the disease. This statement is supported by multiple observations.

    Site and sensitivity

    Firstly, anatomical site of low and high sun exposure predicts patterns of melanoma. In general, the relative density of melanoma is highest on body sites receiving more sun exposure in both sexes and lowest on sites receiving little (scalp in women and buttocks in both sexes).1 2 Furthermore, the difference in the patterns of sun exposure between the sexes is consistent with differences in the most common position of melanoma (trunk in men, lower extremities in woman).3

    The incidence of melanoma is also much higher in people of races who tend to burn rather than tan.1 The age standardised incidence of melanoma in non-Hispanic white people (populations of mainly European origin) in New Mexico is an order of magnitude greater than that in Hispanic whites, with similar results …

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