{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T03:23:36Z","timestamp":1772940216538,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"6411","license":[{"start":{"date-parts":[[1984,1,14]],"date-time":"1984-01-14T00:00:00Z","timestamp":442886400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1984,1,14]]},"abstract":"<jats:p>Between 1 April 1979 and 31 March 1981, 904 residents of the four western provinces of Canada (population 6.5 million), were diagnosed as suffering from primary cutaneous malignant melanoma. Of 801 patients aged 20-79 years, 665 (83%) were interviewed along with control subjects chosen at random from the general population and matched for age, sex, and province. After exclusion of 70 subjects with lentigo maligna or acral lentiginous melanoma, comparisons of the 595 case-control pairs showed that light hair, skin, and eye colour, a history of heavy freckling in adolescence, and a tendency to burn readily and tan poorly in the sun were significant risk factors for melanoma. The strongest primary associations were with blond hair (relative risk 7.1 compared with black hair), light colour of unexposed skin (relative risk 2.4), and severe freckling (relative risk 2.1). These associations were independent of ethnic origin and of recorded amount of exposure to the sun and were somewhat stronger for superficial spreading than for nodular melanoma. This study is the largest and most detailed of an incident series of melanomas to be published to date. The results were consistent with other studies reporting associations between melanoma and poor tanning ability, a tendency to burn easily, and a history of sunburn and showed that light hair colour was the strongest risk factor for the disease.<\/jats:p>","DOI":"10.1136\/bmj.288.6411.99","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"99-102","source":"Crossref","is-referenced-by-count":154,"title":["Pigmentation and skin reaction to sun as risk factors for cutaneous melanoma: Western Canada Melanoma Study."],"prefix":"10.1136","volume":"288","author":[{"given":"J M","family":"Elwood","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R P","family":"Gallagher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G B","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J J","family":"Spinelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J C","family":"Pearson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W","family":"Threlfall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1984,1,14]]},"reference":[{"key":"ref_1","first-page":"913","article-title":"Trends in mortality from primary tumours of skin in Canada","volume":"110","author":"Elwood, J.M.; Lee, J.A.H.","year":"1974","unstructured":"Elwood JM, Lee JAH. Trends in mortality from primary tumours of skin in Canada. Can Med AssocJ 1974;110:913-5.","journal-title":"Can Med AssocJ"},{"key":"ref_2","first-page":"91","article-title":"Secular trends in mortality from malignant melanoma","volume":"45","author":"Lee, J.A.H.; Carter, A.P.","year":"1970","unstructured":"Lee JAH, Carter AP. Secular trends in mortality from malignant melanoma. Journal of the National Cancer Institute 1970;45:91-7.","journal-title":"Journal of the National Cancer Institute"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1002\/ijc.2910260602","article-title":"An analysis of trends in mortality from malignant melanoma of the skin in Australia","volume":"26","author":"Holman, C.D.J.; James, I.R.; Gattey, P.H.; Armstrong, B.K.","year":"1980","unstructured":"Holman CDJ, James IR, Gattey PH, Armstrong BK. An analysis of trends in mortality from malignant melanoma of the skin in Australia. 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Some geographical aspects of the mortality from melanoma in Europeans. MedJ7 Aust 1956;i:1082-7."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1093\/ije\/3.4.325","article-title":"Relationship of melanoma and other skin cancer mortality to latitude and ultraviolet radiation in the United States and Canada","volume":"3","author":"Elwood, J.M.; Lee, J.A.H.; Walter, S.D.; Mo, T.; Green, A.E.S.","year":"1974","unstructured":"Elwood JM, Lee JAH, Walter SD, Mo T, Green AES. Relationship of melanoma and other skin cancer mortality to latitude and ultraviolet radiation in the United States and Canada. Int J Epidemiol 1974;3: 325-32.","journal-title":"Int J Epidemiol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"461","DOI":"10.2105\/AJPH.66.5.461","volume":"66","author":"Fears, T.R.; Scotto, J.; cancer, Schneiderman M.A.Skin; melanoma; sunlight","year":"1976","unstructured":"Fears TR, Scotto J, Schneiderman MA. Skin cancer, melanoma, and sunlight. 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