UV exposure and the risk of cutaneous melanoma in skin of colour

Research led by the University of Texas at Austin found that ultraviolet (UV) light exposure may not be an important risk factor for melanoma development in people with skin of colour.

A systematic review published online ahead of print in JAMA Dermatology (Dec. 16, 2020), assessed the published data regarding the association between UV exposure and the risk of cutaneous melanoma in skin of colour.

The study’s authors note that current evidence supports UV exposure as an important risk factor for cutaneous melanoma in fair-skinned populations; however, the evidence for this association in skin of colour is less certain.

For the review, investigators conducted a search of PubMed, Cochrane, and Web of Science databases. Only peer-reviewed original studies were screened in full text. Eligible studies analyzed UV exposure as a risk factor for cutaneous melanoma in people with skin of colour, which was defined as: any race or ethnicity other than non-Hispanic White; Fitzpatrick skin types IV through VI; or tanning ability of rarely or never burns.

Measures of UV exposure included UV index, irradiance, latitude, history of phototherapy, and history of sunburn. Evidence quality was assessed using criteria from the Oxford Centre for Evidence-Based Medicine.

Researchers screened 11,059 database records, 548 full-text articles were assessed, and 13 of the articles met inclusion criteria. Study types included seven ecological studies, five cohort studies, and one case-control study. All studies used race and/or ethnicity to categorize the participants and more than 7,700 melanomas in skin of colour were included.

Of the 13 studies that met inclusion criteria, 11 found no association between UV exposure and melanoma in skin of colour, one study showed a small positive relationship in Black males, and one showed a weak association in Hispanic males.

“Current recommendations promoting UV protection for melanoma prevention in skin of colour are not supported by most current studies,” the researchers wrote. “However, the evidence is of moderate to low quality, and further research is required to fully elucidate this association.”