RESUMO
The incidence of cutaneous melanoma (CM) has increased in the last decade. Some risk factors are well known, but there are other possible risk factors being studied, such as those involving nutrition. The objective of this case-control study was to assess the association between diet and CM. Classical risk factors, dietary intake, and body mass index were assessed. Binary logistic regression was used to study the association between dietary intake and the risk for CM. Classical risk factors associated with CM were confirmed. The findings suggest that some foods rich in vitamins A and D and phytochemicals may be related to CM.
Assuntos
Dieta/estatística & dados numéricos , Melanoma/epidemiologia , Compostos Fitoquímicos , Neoplasias Cutâneas/epidemiologia , Vitamina A , Vitamina D , Adulto , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Frutas , Humanos , Incidência , Ceratose Actínica/epidemiologia , Lentigo/epidemiologia , Modelos Logísticos , Masculino , Melanose/epidemiologia , Pessoa de Meia-Idade , Nevo/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Fatores de Proteção , Fatores de Risco , Luz Solar , Protetores Solares/uso terapêutico , VerdurasRESUMO
OBJECTIVE: The objective of the study was to examine the association between occupational exposure to pesticides and cutaneous melanoma, controlling for all possible confounders. METHODS: A pooled analysis of two case-control studies was conducted in two different geographic areas (Italy and Brazil). Detailed pesticides exposure histories were obtained. RESULTS: Ever use of any pesticide was associated with a high risk of cutaneous melanoma (odds ratio 2.58; 95% confidence interval 1.18-5.65) in particular exposure to herbicides (glyphosate) and fungicides (mancozeb, maneb), after controlling for confounding factors. When subjects were exposed to both pesticides and occupational sun exposure, the risk increased even more (odds ratio 4.68; 95% confidence interval 1.29-17.0). CONCLUSIONS: The study suggests an augmented risk of cutaneous melanoma among subjects with exposure to pesticides, in particular among those exposed to occupational sun exposure.
Assuntos
Melanoma/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Praguicidas/toxicidade , Neoplasias Cutâneas/epidemiologia , Luz Solar/efeitos adversos , Adulto , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Fungicidas Industriais/toxicidade , Glicina/análogos & derivados , Glicina/toxicidade , Herbicidas/toxicidade , Humanos , Itália/epidemiologia , Masculino , Maneb/toxicidade , Melanoma/etiologia , Pessoa de Meia-Idade , Doenças Profissionais/etiologia , Razão de Chances , Fatores de Risco , Neoplasias Cutâneas/etiologia , Inquéritos e Questionários , Adulto Jovem , Zineb/toxicidade , GlifosatoRESUMO
BACKGROUND: Incidences of primary cutaneous melanoma (CM) have risen over the last few decades, mainly among populations of White European extraction. Some risk factors for melanoma have been clearly established, but other potential risk factors, such as exposure to pesticides, are currently under study. METHODS: A case-control study on melanoma was conducted during 2012 and 2013 at three dermatological reference centers in Porto Alegre, Brazil. A total of 191 CM patients and sex- and age-matched control subjects were enrolled in the study. Data on domestic and occupational use of pesticides and the risk factors already established for CM were collected. Multivariate logistic regression was used to study the association between exposure to pesticides and melanoma risk. RESULTS: Subjects exposed to pesticides had twice the level of risk for melanoma (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.03-6.89). When pesticides were used indoors for >10 years, the risk for CM increased further (OR 2.84, 95% CI 1.56-5.33). A high frequency of indoor use of pesticides (four or more times per year) was associated with a 44% increase in the risk for melanoma (OR 1.44, 95% CI 1.11-3.49). The domestic use of pesticides outdoors was not associated with increased risk. Subjects exposed to pesticides at an occupational level were at four times greater risk than subjects who were not occupationally exposed (OR 4.23, 95% CI 1.94-6.31). CONCLUSIONS: These findings indicate that the general use of pesticides, particularly indoor domestic use, frequently and over a long period, may be an independent environmental risk factor for CM.
Assuntos
Poluição do Ar em Ambientes Fechados/efeitos adversos , Melanoma/epidemiologia , Exposição Ocupacional/efeitos adversos , Praguicidas/toxicidade , Características de Residência , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Cor de Olho , Feminino , Cor de Cabelo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Pigmentação da Pele , Queimadura Solar/complicaçõesRESUMO
Simple and reliable tools for identifying patients at high risk for melanoma with preventive measures have important public health implications. An individual risk score for cutaneous melanoma was constructed and externally validated. With the summary coefficients of the risk factors for cutaneous melanoma, derived from a meta-analysis, a melanoma risk score was tested in an Italian population and externally validated in a Brazilian population. Common nevi, skin and hair color, freckles, and sunburns in childhood were the variables included in the final predictive model. The discriminatory ability of the models was assessed by the receiver operating characteristic (ROC) curve. The performance of the model was also evaluated by conducting an external validation. The area under the curve (AUC) of the candidate model was 0.79 (95% confidence interval: 0.75-0.82). The same model, when applied in the Brazilian population, presented an AUC of 0.79 (95% confidence interval: 0.70-0.86). At the cut-off level of 3 and more, 89 and 80% of the melanoma cases were correctly classified as 'at risk for melanoma' in the Italian and in the Brazilian populations, respectively. The risk model is a simple tool that identifies patients for preventive measures and may be used with reasonable confidence in different populations. The risk model may help family doctors in referring patients to dermatological clinics and thus improve early diagnosis.