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December 16, 2020

Challenges and Controversy in Determining UV Exposure as a Risk Factor for Cutaneous Melanoma in Skin of Color

Author Affiliations
  • 1University of Iowa Hospitals and Clinics, Department of Dermatology, Iowa City
JAMA Dermatol. Published online December 16, 2020. doi:10.1001/jamadermatol.2020.4615

Despite the lower prevalence of melanoma in people of color compared with the White population, there is increased morbidity and mortality as evidenced by more advanced stage at diagnosis and lower 5-year survival rates.1,2 This disparity persists in all racial minority groups with localized melanoma and increasingly in Hispanic patients with regional or distant disease.3 Exposure to UV radiation, especially high intermittent exposure during childhood, is a significant environmental risk factor for melanoma in individuals with fair skin.1 However, for populations of color, in which melanomas are commonly found in sun-protected locations, such as acral, subungual, and mucosal surfaces, the role of UV exposure as a risk factor is much less clear.1 This is a recognized gap in knowledge that highlights the need to further identify and stratify risk factors for melanoma in this population. Evidence is needed to inform meaningful recommendations regarding melanoma prevention, screening, and treatment to improve outcomes in this population.1,2

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