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Epidemiological studies suggested that farmers and agricultural workers are at an increased risk of <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> because they were exposed to pesticides. However, little is known about the relationship between pesticides and <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the association between exposure to pesticides and <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> by systematically reviewing the literature. Secondary aim was to determine the categories of pesticides mainly involved in <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of the literature was performed up to September 2018 using <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>, Embase and Web of Science. Studies assessing <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> risk in licensed pesticide applicators were considered. Strict criteria were established to select independent studies and risk estimates; random effect models, taking into account heterogeneity, were applied. A pooled risk estimate for <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content> was calculated for the use of each type of pesticide and type of exposure. Between\u2010study and estimate heterogeneity was assessed and publication bias investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of nine studies (two case\u2013controls and seven cohorts) comprising 184\u00a0389 unique subjects were included. The summary relative risks for the categories \u2018herbicides \u2013 ever exposure\u2019, \u2018insecticides \u2013 ever exposure\u2019, \u2018any pesticide \u2013 ever exposure\u2019 and \u2018any pesticide \u2013 high exposure\u2019 resulted 1.85 [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>): 1.01, 3.36], 1.57 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.58, 4.25), 1.31 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.85, 2.04) and 2.17 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.45, 10.36), respectively. Herbicides and insecticides had no between\u2010study heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup><jats:italic>\u00a0<\/jats:italic>=\u00a00%), while a significant heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0&gt;\u00a050%) was detected for the high exposure to any pesticide. No indication for publication bias was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Individuals exposed to herbicides are at an increased risk of <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>. Future properly designed observational studies are required to confirm this finding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.15964","type":"journal-article","created":{"date-parts":[[2019,9,21]],"date-time":"2019-09-21T09:14:51Z","timestamp":1569057291000},"page":"691-708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["The association between pesticide use and cutaneous melanoma: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"34","author":[{"given":"I.","family":"Stanganelli","sequence":"first","affiliation":[{"name":"Skin Cancer Unit Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Meldola Italy"},{"name":"Dermatology Department University of Parma Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.B.","family":"De 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