Discerning individuals at elevated risk for cutaneous melanoma

Reasonable data exist to predict which groups of individuals are at elevated risk for the development of cutaneous melanoma and which groups of individuals are at lower-than-average risk. These data derive from numerous case-control studies conducted since 1960. MacKie et al¹ have recently published a mathematical model in which the relative risk for men possessing four identified risk factors was nearly 600-fold higher than that for men with none of these factors; similarly for women, a nearly 200-fold difference was projected. This model is discussed in detail later (see Multifactorial Models). This article reviews the currently identified risk factors (Table 1) with efforts to recognize when risk factors are acting independently and when they are simply acting as proxies for one another. A large group of diverse factors have been reported in single studies that have not been confirmed in other studies or as yet have not been reevaluated. Table 2 lists those factors that on the basis of current evidence are unlikely to be of great importance.