Cutaneous malignant melanoma incidence is strongly associated with European depigmented skin type regardless of ambient ultraviolet radiation levels: evidence from Worldwide population-based data

Wenpeng You; Renata Henneberg; Brendon J Coventry; Maciej Henneberg; Wenpeng You; Renata Henneberg; Brendon J Coventry; Maciej Henneberg

doi:10.3934/publichealth.2022026

AIMS Public Health

2022, Volume 9, Issue 2: 378-402. doi: 10.3934/publichealth.2022026

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Research article

Cutaneous malignant melanoma incidence is strongly associated with European depigmented skin type regardless of ambient ultraviolet radiation levels: evidence from Worldwide population-based data

1.
Biological Anthropology and Comparative Anatomy Unit, Adelaide Medical School, the University of Adelaide, Adelaide, South Australia, Australia
2.
Discipline of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia
3.
Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland

Received: 28 December 2021 Revised: 25 February 2022 Accepted: 07 March 2022 Published: 17 March 2022

Current public health advice is that high ultraviolet radiation (UVR) exposure is the primary cause of Malignant Melanoma of skin (CMM), however, despite the use of sun-blocking products incidence of melanoma is increasing. To investigate the UVR influence on CMM incidence worldwide WHO, United Nations, World Bank databases and literature provided 182 country-speciﬁc melanoma incidence estimates, daily UVR levels, skin colour (EEL), socioeconomic status (GDP PPP), magnitude of reduced natural selection (Ibs), ageing, urbanization, percentage of European descendants (Eu%), and depigmentation (blonde hair colour), for parametric and non-parametric correlations, multivariate regressions and analyses of variance. Worldwide, UVR levels showed negative correlation with melanoma incidence (“rho” = −0.515, p < 0.001), remaining significant and negative in parametric partial correlation (r = −0.513, p < 0.001) with other variables kept constant. After standardising melanoma incidence for Eu%, melanoma correlation with UVR disappeared completely (“rho” = 0.004, p = 0.967, n = 127). The results question classical views that UVR causes melanoma. No correlation between UVR level and melanoma incidence was present when Eu% (depigmented or light skin type) was kept statistically constant, even after adjusting for other known variables. Countries with lower UVR levels and more Eu% (depigmented or light skin people) have higher melanoma incidence. Critically, this means that individual genetic low skin pigmentation factors predict melanoma risk regardless of UVR exposure levels, and even at low-UVR levels.
- cutaneous malignant melanoma (CMM),
- incidence,
- UV levels,
- depigmentation,
- adaptation,
- world-wide data
Citation: Wenpeng You, Renata Henneberg, Brendon J Coventry, Maciej Henneberg. Cutaneous malignant melanoma incidence is strongly associated with European depigmented skin type regardless of ambient ultraviolet radiation levels: evidence from Worldwide population-based data[J]. AIMS Public Health, 2022, 9(2): 378-402. doi: 10.3934/publichealth.2022026

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Abstract

Current public health advice is that high ultraviolet radiation (UVR) exposure is the primary cause of Malignant Melanoma of skin (CMM), however, despite the use of sun-blocking products incidence of melanoma is increasing. To investigate the UVR influence on CMM incidence worldwide WHO, United Nations, World Bank databases and literature provided 182 country-speciﬁc melanoma incidence estimates, daily UVR levels, skin colour (EEL), socioeconomic status (GDP PPP), magnitude of reduced natural selection (Ibs), ageing, urbanization, percentage of European descendants (Eu%), and depigmentation (blonde hair colour), for parametric and non-parametric correlations, multivariate regressions and analyses of variance. Worldwide, UVR levels showed negative correlation with melanoma incidence (“rho” = −0.515, p < 0.001), remaining significant and negative in parametric partial correlation (r = −0.513, p < 0.001) with other variables kept constant. After standardising melanoma incidence for Eu%, melanoma correlation with UVR disappeared completely (“rho” = 0.004, p = 0.967, n = 127). The results question classical views that UVR causes melanoma. No correlation between UVR level and melanoma incidence was present when Eu% (depigmented or light skin type) was kept statistically constant, even after adjusting for other known variables. Countries with lower UVR levels and more Eu% (depigmented or light skin people) have higher melanoma incidence. Critically, this means that individual genetic low skin pigmentation factors predict melanoma risk regardless of UVR exposure levels, and even at low-UVR levels.

Abbreviations

WHO

World Health Organization

ICD

International Classification of Diseases

C43

Malignant melanoma coded as C43 as per International Classification of Diseases

CMM

cutaneous malignant melanoma, a common abbreviation of C43 in academics

The United Nations

I_bs

Biological State Index

GDP PPP

Gross Domestic Product at Purchasing Power Parity

UVR

Ultraviolet radiation

SES

Socioeconomic status

BCC

basal cell carcinoma

SCC

squamous cell carcinoma

Acknowledgments

We thank Dr John Relethford for providing a large part of data on skin colour.

Ethics approval and consent to participate

This study does not involve any human participants or animals. Ethical approval and consent are not required.

Availability of data and material

All data for this study are publicly available from the United Nations (UN) Agencies' websites. The purpose of using these in this study meets the terms and conditions of the relevant UN agencies. The formal permission is not required to download and analyse the data in this study. The data sources have been detailed in the “Materials and Methods”.

Conflict of interest

The authors have no competing interests to declare.

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