Leslie K. Dennis, MS, PhD; Laura E. Beane Freeman, PhD; Marta J. VanBeek, MD
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, firstname.lastname@example.org.
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.
Originally developed to protect against sunburn, sunscreen has been assumed to prevent skin cancer. However, conflicting reports include claims that sunscreen increases risk for melanoma.
To examine the strength and consistency of associations between melanoma and sunscreen use in the published literature.
A comprehensive MEDLINE search of articles published from 1966 to 2003 that reported information on sunscreen use and melanoma in humans.
Analytic studies reporting data on sunscreen use before diagnosis of melanoma.
Two independent reviewers extracted data. Inconsistencies were rereviewed until agreement was achieved. When necessary, a third party resolved discrepancies.
Odds ratios were pooled across studies by using standard meta-analytic techniques. Pooled odds ratios for ever use among 18 heterogeneous studies did not support an association between melanoma and sunscreen use. Variation among odds ratios was explained by studies that did not adjust for confounding effects of sun sensitivity. The lack of a doseresponse effect with frequency of use (never, sometimes, or always) or years of use provided further evidence of a null association.
No association was seen between melanoma and sunscreen use. Failure to control for confounding factors may explain previous reports of positive associations linking melanoma to sunscreen use. In addition, it may take decades to detect a protective association between melanoma and use of the newer formulations of sunscreens.
Dennis LK, Beane Freeman LE, VanBeek MJ. Sunscreen Use and the Risk for Melanoma: A Quantitative Review. Ann Intern Med. 2003;139:966–978. doi: 10.7326/0003-4819-139-12-200312160-00006
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Published: Ann Intern Med. 2003;139(12):966-978.
Cancer Screening/Prevention, Emergency Medicine, Hematology/Oncology, Prevention/Screening, Pulmonary/Critical Care.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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