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Sunscreen Use and the Risk for Melanoma: A Quantitative Review

Leslie K. Dennis, MS, PhD; Laura E. Beane Freeman, PhD; and Marta J. VanBeek, MD
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From the College of Public Health and College of Medicine, University of Iowa, Iowa City, Iowa.

Grant Support: In part by the National Cancer Institute, grant number 1R03CA88834-01.

Potential Financial Conflicts of Interest: None disclosed.

Corresponding Author: Leslie K. Dennis, MS, PhD, Department of Epidemiology, College of Public Health, University of Iowa, 200 Hawkins Drive, C21H-GH, Iowa City, IA 52242; e-mail, leslie-dennis@uiowa.edu.

Current Author Addresses: Dr. Dennis: Department of Epidemiology, College of Public Health, University of Iowa, 200 Hawkins Drive, C21H-GH, Iowa City, IA 52242.

Dr. Beane Freeman: Cancer Prevention Fellowship Program, Division of Cancer Prevention, NCI, Executive Plaza North, Suite 3109, 6130 Executive Boulevard, MSC 7361, Bethesda, MD 20892-7361.

Dr. VanBeek: Department of Dermatology, College of Medicine, University of Iowa, 200 Hawkins Drive, BT2045-1, Iowa City, IA 52242.

Author Contributions: Conception and design: L.K. Dennis.

Analysis and interpretation of the data: L.K. Dennis, L.E. Beane Freeman, M.J. VanBeek.

Drafting of the article: L.K. Dennis, L.E. Beane Freeman, M.J. VanBeek.

Critical revision of the article for important intellectual content: L.K. Dennis, L.E. Beane Freeman, M.J. VanBeek.

Final approval of the article: L.K. Dennis, L.E. Beane Freeman, M.J. VanBeek.

Provision of study materials or patients: L.K. Dennis.

Statistical expertise: L.K. Dennis.

Obtaining of funding: L.K. Dennis.

Administrative, technical, or logistic support: L.K. Dennis, M.J. VanBeek.

Collection and assembly of data: L.K. Dennis, L.E. Beane Freeman, M.J. VanBeek.

Ann Intern Med. 2003;139(12):966-978. doi:10.7326/0003-4819-139-12-200312160-00006
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Table 2 describes the 20 studies from 23 published articles included in the meta-analysis. The earliest published case–control study (16) was excluded because it examined use of sun lotion or oil rather than sunscreen. One study (17) included hair, sweat, dirt, dead skin, and sunscreen use as measures of protection against ultraviolet radiation “always when in the sun” (Table 2). Therefore, we excluded it from the pooled odds ratio because it was not comparable to other studies. The remaining 18 studies included no cohort studies, 9 population-based case–control studies (56, 8, 1825) (including 1 population-based study of adolescents), 7 non–population-based studies (7, 2632), and 2 case–control studies (9, 33) in which the control group was not clearly identified. Two of the 18 studies reported odds ratios for both sunscreen and sun lotions or oils (Table 2); however, only odds ratios for sunscreen use were pooled in the analyses.

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Figure 1.
Literature search for articles on risk for melanoma and sunscreen use.

MeSH = Medical Subject Heading.

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Figure 2.
Odds ratios and 95% CIs for ever use of sunscreen for the 18 studies, sorted by first year of data collection; overall pooled estimate, based on a random-effects dose–response model; and pooled estimate including only studies that adjusted for sun sensitivity (n= 9).


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Summary for Patients

Sunscreen Use and Melanoma

The summary below is from the full report titled “Sunscreen Use and the Risk for Melanoma: A Quantitative Review.” It is in the 16 December 2003 issue of Annals of Internal Medicine (volume 139, pages 966-978). The authors are L.K. Dennis, L.E. Beane, and M.J. VanBeek.


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