Original Article
Melanoma, Altitude, and UV-B Radiation
Melanoma, altitud y radiación UVB
P. Aceituno-Maderaa,
, A. Buendía-Eismanb, F.J. Olmoc, J.J. Jiménez-Moleónd, S. Serrano-Ortegab
Corresponding author
a Servicio de Dermatología, Hospital Clínico Universitario San Cecilio, Granada, Spain
b Departamento de Dermatología, Facultad de Medicina, Universidad de Granada, Spain
c Departamento de Física Aplicada, Facultad de Ciencias, Universidad de Granada, Granada, Spain
d Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain
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"apellidos" => "Serrano-Ortega" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Clínico Universitario San Cecilio, Granada, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Dermatología, Facultad de Medicina, Universidad de Granada, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Física Aplicada, Facultad de Ciencias, Universidad de Granada, Granada, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Melanoma, altitud y radiación UVB" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-04-05" "fechaAceptado" => "2010-08-23" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec84865" "palabras" => array:3 [ 0 => "Melanoma incidence" 1 => "Altitude" 2 => "UVB radiation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84864" "palabras" => array:3 [ 0 => "Incidencia melanoma" 1 => "Altitud" 2 => "Radiación UVB" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">UV radiation is the main modifiable risk factor for the development of cutaneous melanoma. Many people in the Spanish province of Granada live at high altitudes and, therefore, receive high doses of UV-B radiation. The aims of this study were to assess the possible association between melanoma and altitude and to measure the daily erythemal dose at different altitudes.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An epidemiological study was carried out between 1982 and 2007 to assess the relationship between altitude, daily erythemal dose, and the prevalence of melanoma. We calculated the prevalence of melanoma in patients with a clinical and histological diagnosis of melanoma at Hospital Clínico Universitario San Cecilio in Granada, Spain. All individuals were required to be residents of the province of Granada in order to be included in the study. The prevalence of melanoma was calculated for altitude intervals of 100<span class="elsevierStyleHsp" style=""></span>m. Daily erythemal dose was estimated using measures of UV-B radiation obtained with pyranometers at altitudes of 0, 680, 1200, and 3398 m above sea level during the Evaluation of the Effects of Elevation and Aerosols on UV Radiation (VELETA) 2002 field campaign.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The highest prevalence of melanoma was found between 1400 and 1499<span class="elsevierStyleHsp" style=""></span>m above sea level (the interval at which the highest settlements are found), with a rate of 2.36 cases per 1000 inhabitants (95% confidence interval, 0.64–6.03). Above 700<span class="elsevierStyleHsp" style=""></span>m, the daily erythemal dose increased exponentially with increasing altitude.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We observed a tendency toward increased prevalence of melanoma at higher altitude, with higher prevalences observed beyond 700<span class="elsevierStyleHsp" style=""></span>m above sea level.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La radiación ultravioleta (UV) es el principal factor de riesgo ambiental modificable en el desarrollo del melanoma cutáneo. Muchas de las poblaciones de nuestra provincia están situadas a gran altitud, recibiendo elevadas dosis de radiación UVB. Nuestro objetivo es analizar una posible asociación entre melanoma y altitud y medir la dosis eritemática diaria a diferentes altitudes.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Realizamos un estudio ecológico, en el que se trató de relacionar la prevalencia de melanoma, la altitud y la dosis eritemática diaria. El periodo de estudio comprendió los últimos 25 años (1982–2007). Calculamos la prevalencia de melanoma con aquellos pacientes diagnosticados clínica e histológicamente de melanoma, procedentes del Hospital Clínico Universitario “San Cecilio”. Los individuos del estudio debían tener su lugar de residencia en la provincia de Granada. Calculamos la prevalencia de melanoma a intervalos de 100<span class="elsevierStyleHsp" style=""></span>m de altitud y estimamos la dosis eritemática diaria a partir de las medidas de radiación UVB realizadas con piranómetros situados a 0, 680, 1.200, 2.100 y 3.398<span class="elsevierStyleHsp" style=""></span>m de altitud durante la campaña VELETA-2002.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de melanoma más alta está situada en el intervalo comprendido entre los 1.400–1.499<span class="elsevierStyleHsp" style=""></span>m a.s.l (intervalo con núcleos de población situados a mayor altitud) con 2,36 por 1.000 habitantes IC al 95% (0,64–6,03) por 1.000 habitantes. A partir de los 700<span class="elsevierStyleHsp" style=""></span>m de altura la dosis eritemática diaria aumenta de forma exponencial a medida que ascendemos en altitud.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Este estudio encuentra una tendencia al aumento en la prevalencia de melanoma al ascender en altitud, siendo más intenso a partir de los 700<span class="elsevierStyleHsp" style=""></span>m a.s.l.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The emerging epidemic of skin cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.B. Ko" 1 => "S. Walton" 2 => "K. Keczkes" 3 => "H.P. 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| 2020 January | 0 | 15 | 15 |
| 2019 December | 0 | 19 | 19 |
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| 2019 May | 1 | 69 | 70 |
| 2019 April | 0 | 18 | 18 |
| 2019 March | 0 | 13 | 13 |
| 2018 September | 0 | 1 | 1 |
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| 2018 July | 0 | 1 | 1 |
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| 2018 March | 0 | 1 | 1 |
| 2018 February | 9 | 4 | 13 |
| 2018 January | 19 | 5 | 24 |
| 2017 December | 29 | 10 | 39 |
| 2017 November | 24 | 7 | 31 |
| 2017 October | 17 | 5 | 22 |
| 2017 September | 21 | 6 | 27 |
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| 2017 July | 38 | 8 | 46 |
| 2017 June | 30 | 16 | 46 |
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| 2017 April | 31 | 11 | 42 |
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| 2016 December | 31 | 5 | 36 |
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| 2016 October | 37 | 21 | 58 |
| 2016 September | 27 | 5 | 32 |
| 2016 August | 38 | 11 | 49 |
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| 2016 June | 11 | 10 | 21 |
| 2016 May | 7 | 15 | 22 |
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| 2016 March | 3 | 7 | 10 |
| 2016 February | 4 | 10 | 14 |
| 2016 January | 8 | 11 | 19 |
| 2015 December | 13 | 4 | 17 |
| 2015 November | 8 | 4 | 12 |
| 2015 October | 9 | 4 | 13 |
| 2015 September | 7 | 1 | 8 |
| 2015 August | 14 | 4 | 18 |
| 2015 July | 21 | 15 | 36 |
| 2015 June | 29 | 3 | 32 |
| 2015 May | 72 | 15 | 87 |
| 2015 April | 31 | 11 | 42 |
| 2015 March | 37 | 6 | 43 |
| 2015 February | 27 | 6 | 33 |
| 2015 January | 23 | 6 | 29 |
| 2014 December | 33 | 13 | 46 |
| 2014 November | 21 | 6 | 27 |
| 2014 October | 33 | 12 | 45 |
| 2014 September | 30 | 13 | 43 |
| 2014 August | 35 | 13 | 48 |
| 2014 July | 44 | 15 | 59 |
| 2014 June | 45 | 14 | 59 |
| 2014 May | 51 | 17 | 68 |
| 2014 April | 29 | 12 | 41 |
| 2014 March | 33 | 17 | 50 |
| 2014 February | 22 | 9 | 31 |
| 2014 January | 36 | 16 | 52 |
| 2013 December | 39 | 7 | 46 |
| 2013 November | 25 | 13 | 38 |
| 2013 October | 25 | 16 | 41 |
| 2013 September | 32 | 25 | 57 |
| 2013 August | 15 | 38 | 53 |
| 2013 July | 37 | 21 | 58 |
| 2013 June | 23 | 16 | 39 |
| 2013 May | 25 | 12 | 37 |
| 2013 April | 29 | 15 | 44 |
| 2013 March | 8 | 5 | 13 |
| 2013 February | 5 | 5 | 10 |
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