UV Exposure and Risk of Melanoma in People of Color

UV exposure is well established as a strong risk factor for cancer; however, information regarding the relationship between UV exposure and cutaneous melanoma in people of color is scarce and controversial. Researchers conducted a literature review on UV exposure and melanoma risk in people of color and found inconsistent and low-quality data. The results of the study were published as part of the American Academy of Dermatology Virtual Meeting Experience 2020.

Researchers conducted a systematic review of PubMed, Cochrane, Web of Science, BIOSIS Citation Index, KCI-Korean Journal Database, MEDLINE, Russian Science Citation Index, and SciELO Citation Index on June 26, 2019, with no time restrictions included. They included only English-language articles from peer-reviewed journals that were ecological studies; prospective and retrospective cohort studies; longitudinal studies; case-control studies; independent studies; randomized, controlled trials; and controlled clinical trials.

Studies in which UV exposure clearly preceded the outcome (melanoma) and studies that included dark-skinned patients (defined as Fitzpatrick skin type IV-VI or all races except non-Hispanic whites or tanning ability of rarely or never burns) were included. The final analysis comprised 21 articles. The researchers noted a “striking paucity” of literature on this topic, with even recent data being inconsistent and of low quality.

Most articles used dark skin types as the reference for comparing relative risks, implying an understanding that the risk for cutaneous melanoma in this group is very low. “From the limited literature available, it is clear that UV exposure is not a significant risk factor for cutaneous melanoma in skin of color,” the researchers wrote. However, the researchers noted that people of color have higher melanoma-related mortality, so there is an increased urgency to understand risk factors in this patient population.

Most current public health messaging addresses UV avoidance and sunscreen application, which is likely an ineffective strategy, the authors noted. “UV exposure related public health messaging around melanoma primary prevention in skin of color is misleading and should be revised,” the researchers concluded.

Lopes FCPS, Sleiman MG, Sabastian K, et al. UV Exposure and the Risk for Cutaneous Melanoma in Skin of Color. Presented during the AAD Virtual Meeting Experience 2020, June 12-14, 2020.