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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 24 janvier 2020
Doi : 10.1016/j.jaad.2017.11.049
accepted : 7 November 2017
Age-dependent interaction between sex and geographic ultraviolet index in melanoma risk

Feng Liu-Smith, PhD , Argyrios Ziogas, PhD
 Department of Epidemiology, University of California Irvine, Irvine, California 

Correspondence to: Feng Liu-Smith, PhD, University of California, Irvine, Department of Epidemiology, 256A Irvine Hall, Irvine, CA 92697.University of California, IrvineDepartment of Epidemiology256A Irvine HallIrvineCA92697

Ultraviolet (UV) exposure may not affect melanoma development equally in different sexes and ages. Whether and how these factors interact with each other in relation to melanoma risk is unknown.


This study attempts to estimate interactions among UV index (UVI), sex, and age in melanoma risk.


Melanoma incidence data were collected from 42 cancer registries. Geographic UVI was collected from local satellite stations. Negative binomial regression models were used to estimate the impact of each risk factor and their interactions.


Sex, UVI, and age, as well as interactions between any 2 of these factors, were significantly associated with melanoma risk. In younger age groups, female sex is an independent risk factor for melanoma that is not affected by ambient UV exposure. In older age groups, however, female sex interacts with UV exposure as a risk factor, exhibiting a protective effect. The switching age category is 45 to 49, which correlates with dramatic hormonal changes.


The interaction between sex and UVI is measured at an ecologic level.


The interaction between sex and UVI is age dependent. Female sex is an independent risk factor for early-onset melanoma, but female sex also protects against UV-associated melanoma in older age groups.

The full text of this article is available in PDF format.

Key words : epidemiology, latitude, melanoma, sex, UV, UVI

Abbreviations used : UV, UVI, UVR

 Funding sources: Supported by NIH/NCI K07 grant (CA160756) (to FLS).
 Conflicts of interest: None declared.
 Reprints not available from the authors.

© 2017  American Academy of Dermatology, Inc.@@#104156@@
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