Despite substantial interest in atypical nevi as melanoma risk factors and precursors, little is known about risk factors for these lesions, or their role in melanoma etiology. Previous case-control studies that have assessed atypical nevi as melanoma risk factors were small and/or clinic based. Similarly, only a few small, clinic-based studies have examined risk factors for atypical nevi. Our primary aims are to 1) conduct a large, population-based, case-control study of nonfamilial melanoma to evaluate atypical nevi, benign nevi, sun sensitivity, and solar exposure as risk factors, and 2) conduct a large, population-based evaluation of risk factors for atypical nevi. In separate analyses, we will explore risk factors associated with melanoma subgroups based on a) presence or absence of atypical nevi, and b) tumor histologic type. As a tertiary aim, we propose a validation substudy that will evaluate whether subjects can accurately self-diagnose atypical nevi. At least 535 cases of melanoma, ascertained through the NH State Cancer Registry, will be enrolled over a five year study period. We will enroll 800 population controls identified from drivers' license lists (age 65 or less), and medicare beneficiary lists (age greater than 65). Consenting subjects will complete a telephone interview, conduct skin self-examination, and participate in a dermatologist-conducted skin examination. Based on the dermatology examination, all subjects will be classified as """"""""with"""""""" or """"""""without"""""""" atypical nevi. Our statistical approach will include two primary case-control analyses to evaluate 1) risk factors for melanoma, and 2) risk factors for atypical nevi. In addition, we will conduct separate case-control comparisons to explore risk factors for specific melanoma subsets. Our approach will elucidate the etiology of melanoma, and identify risk factors for atypical nevi. Finally, we will evaluate subjects' ability to self-screen for atypical nevi by comparing the results of self-examination to the results of the dermatologist examination. The ability to self-diagnose atypical nevi has important implications for melanoma prevention.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA066032-04
Application #
2871843
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Verma, Mukesh
Project Start
1996-04-01
Project End
2001-01-31
Budget Start
1999-02-01
Budget End
2000-01-31
Support Year
4
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Dartmouth College
Department
Family Medicine
Type
Schools of Medicine
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755
Davies, John R; Chang, Yu-mei; Bishop, D Timothy et al. (2015) Development and validation of a melanoma risk score based on pooled data from 16 case-control studies. Cancer Epidemiol Biomarkers Prev 24:817-24
Titus, L J; Clough-Gorr, K; Mackenzie, T A et al. (2013) Recent skin self-examination and doctor visits in relation to melanoma risk and tumour depth. Br J Dermatol 168:571-6
Titus, L (2013) Skin self-examination and the ABCDE rule in the early diagnosis of melanoma: is the game over? Reply from author. Br J Dermatol 168:1371-2
Chang, Yu-mei; Barrett, Jennifer H; Bishop, D Timothy et al. (2009) Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls. Int J Epidemiol 38:814-30
Clough-Gorr, Kerri M; Titus-Ernstoff, Linda; Perry, Ann E et al. (2008) Exposure to sunlamps, tanning beds, and melanoma risk. Cancer Causes Control 19:659-69
Titus-Ernstoff, Linda; Ding, Jiao; Perry, Ann E et al. (2007) Factors associated with atypical moles in New Hampshire, USA. Acta Derm Venereol 87:43-8
Titus-Ernstoff, Linda; Perry, Ann E; Spencer, Steven K et al. (2006) Multiple primary melanoma: two-year results from a population-based study. Arch Dermatol 142:433-8
Titus-Ernstoff, Linda; Perry, Ann E; Spencer, Steven K et al. (2005) Pigmentary characteristics and moles in relation to melanoma risk. Int J Cancer 116:144-9
Tran, Tina P; Titus-Ernstoff, Linda; Perry, Ann E et al. (2002) Alteration of chromosome 9p21 and/or p16 in benign and dysplastic nevi suggests a role in early melanoma progression (United States). Cancer Causes Control 13:675-82