Methodological procedure for evaluation of risk factors for cutaneous malignant melanoma in a representative sample of the Tuscan population

Aim. The incidence of melanoma is rising steadily in countries with white populations and, despite all attempts at treatment, a considerable proportion of patients with malignant melanoma die of the disease. Primary prevention is, therefore, important to reduce mortality at present. Here we report the results of a case-control study of melanoma risk factors conducted in Tuscany (Italy) in 2002-2003. Methods. One-hundred-forty Italian subjects who underwent surgical exeresis of non familial cutaneous malignant melanoma and 280 age- and gender-matched controls filled in a standardized questionnaire about occupational and recreational sun exposure, underwent complete skin examination by a dermatologist to assess the number of nevi and presence of clinically atypical nevi, eye color, hair color and Fitzpatrick phototype. Moreover skin color was measured with a Minolta CR-300 colorimeter. Univariate and stepwise logistic regression statistical analysis were performed to analyze differences in variables between melanoma patients and control subjects. Results. We demonstrated a highly significant difference between controls and melanoma patients in our study: in nevi number and presence of atypical nevi, constitutional skin color (Fitzpatrick phototype was completely explained by colorimetric variables of skin color) and eye color. Conclusion. We agree with what was recently proposed by others that objective skin color measurements must be combined with phenotype parameters and sun exposure history for exact assessment of individual risk.