@article{3156648,
    title = "Obesity and risk of malignant melanoma: A meta-analysis of cohort and
case-control studies",
    author = "Sergentanis, Theodoros N. and Antoniadis, Antonios G. and Gogas, Helen and J. and Antonopoulos, Constantine N. and Adami, Hans-Olov and Ekbom, and Anders and Petridou, Eleni Th.",
    journal = "EUROPEAN JOURNAL OF CANCER",
    year = "2013",
    volume = "49",
    number = "3",
    pages = "642-657",
    publisher = "Elsevier Sci Ltd, Exeter, United Kingdom",
    doi = "10.1016/j.ejca.2012.08.028",
    keywords = "Melanoma; Obesity; Body mass index; Body surface area; Meta-analysis;
Sunlight",
    abstract = "Although obesity is an established risk factor for several cancer types,
its possible role in the etiology of malignant melanoma remains unclear.
This meta-analysis aims to examine the association between obesity and
melanoma risk, exploring any tentative gender-specific associations.
After the identification of eligible studies, we estimated pooled effect
estimates (odds ratios and relative risks), undertook a meta-regression
analysis and analyzed separately risk of malignant melanoma among males
and females in relation to body mass index (BMI) and body surface area
(BSA). Out of the 21 eligible articles, 11 used a case-control design
encompassing 4460 cases/6342 controls; 10 used a cohort design whose
total size comprised 7895 incident cases/6,368,671 subjects. Among
males, the pooled effect estimate was 1.31 (95% confidence interval
(CI): 1.18-1.45) for overweight and 1.31 (95% CI: 1.19-1.44) for obese.
Meta-regression revealed no significant slope, most probably due to the
underlying plateau in effect estimates. Among females, no significant
association was documented; the pooled effect estimate for overweight
and obese subjects was 0.98 (95% CI: 0.92-1.05) and 0.99 (95% CI:
0.83-1.18), respectively. Noticeably, there was evidence for confounding
between sunlight exposure and obesity in females. All results were
reproducible upon analyses on BSA. In conclusion, overweight and obesity
is associated with increased risk of malignant melanoma among males.
Meticulous assessment of sunlight exposure is needed especially in
women, since self limited public sun exposure may be prevalent among
overweight or obese females. Higher-order associations between BMI and
melanoma risk should be addressed and examined by the future studies.
(C) 2012 Elsevier Ltd. All rights reserved."
}