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
Autor para correspondencia
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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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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| año/Mes | Html | Total | |
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| 2020 Octubre | 19 | 16 | 35 |
| 2020 Septiembre | 14 | 20 | 34 |
| 2020 Agosto | 20 | 22 | 42 |
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| 2020 Junio | 20 | 38 | 58 |
| 2020 Mayo | 18 | 33 | 51 |
| 2020 Abril | 19 | 24 | 43 |
| 2020 Marzo | 29 | 18 | 47 |
| 2020 Febrero | 2 | 6 | 8 |
| 2020 Enero | 0 | 15 | 15 |
| 2019 Diciembre | 0 | 19 | 19 |
| 2019 Noviembre | 0 | 5 | 5 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 0 | 6 | 6 |
| 2019 Agosto | 0 | 4 | 4 |
| 2019 Julio | 0 | 7 | 7 |
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| 2019 Mayo | 1 | 69 | 70 |
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| 2019 Marzo | 0 | 13 | 13 |
| 2018 Septiembre | 0 | 1 | 1 |
| 2018 Agosto | 0 | 8 | 8 |
| 2018 Julio | 0 | 1 | 1 |
| 2018 Abril | 0 | 1 | 1 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 9 | 4 | 13 |
| 2018 Enero | 19 | 5 | 24 |
| 2017 Diciembre | 29 | 10 | 39 |
| 2017 Noviembre | 24 | 7 | 31 |
| 2017 Octubre | 17 | 5 | 22 |
| 2017 Septiembre | 21 | 6 | 27 |
| 2017 Agosto | 40 | 6 | 46 |
| 2017 Julio | 38 | 8 | 46 |
| 2017 Junio | 30 | 16 | 46 |
| 2017 Mayo | 37 | 7 | 44 |
| 2017 Abril | 31 | 11 | 42 |
| 2017 Marzo | 30 | 23 | 53 |
| 2017 Febrero | 23 | 13 | 36 |
| 2017 Enero | 11 | 9 | 20 |
| 2016 Diciembre | 31 | 5 | 36 |
| 2016 Noviembre | 25 | 7 | 32 |
| 2016 Octubre | 37 | 21 | 58 |
| 2016 Septiembre | 27 | 5 | 32 |
| 2016 Agosto | 38 | 11 | 49 |
| 2016 Julio | 26 | 12 | 38 |
| 2016 Junio | 11 | 10 | 21 |
| 2016 Mayo | 7 | 15 | 22 |
| 2016 Abril | 8 | 6 | 14 |
| 2016 Marzo | 3 | 7 | 10 |
| 2016 Febrero | 4 | 10 | 14 |
| 2016 Enero | 8 | 11 | 19 |
| 2015 Diciembre | 13 | 4 | 17 |
| 2015 Noviembre | 8 | 4 | 12 |
| 2015 Octubre | 9 | 4 | 13 |
| 2015 Septiembre | 7 | 1 | 8 |
| 2015 Agosto | 14 | 4 | 18 |
| 2015 Julio | 21 | 15 | 36 |
| 2015 Junio | 29 | 3 | 32 |
| 2015 Mayo | 72 | 15 | 87 |
| 2015 Abril | 31 | 11 | 42 |
| 2015 Marzo | 37 | 6 | 43 |
| 2015 Febrero | 27 | 6 | 33 |
| 2015 Enero | 23 | 6 | 29 |
| 2014 Diciembre | 33 | 13 | 46 |
| 2014 Noviembre | 21 | 6 | 27 |
| 2014 Octubre | 33 | 12 | 45 |
| 2014 Septiembre | 30 | 13 | 43 |
| 2014 Agosto | 35 | 13 | 48 |
| 2014 Julio | 44 | 15 | 59 |
| 2014 Junio | 45 | 14 | 59 |
| 2014 Mayo | 51 | 17 | 68 |
| 2014 Abril | 29 | 12 | 41 |
| 2014 Marzo | 33 | 17 | 50 |
| 2014 Febrero | 22 | 9 | 31 |
| 2014 Enero | 36 | 16 | 52 |
| 2013 Diciembre | 39 | 7 | 46 |
| 2013 Noviembre | 25 | 13 | 38 |
| 2013 Octubre | 25 | 16 | 41 |
| 2013 Septiembre | 32 | 25 | 57 |
| 2013 Agosto | 15 | 38 | 53 |
| 2013 Julio | 37 | 21 | 58 |
| 2013 Junio | 23 | 16 | 39 |
| 2013 Mayo | 25 | 12 | 37 |
| 2013 Abril | 29 | 15 | 44 |
| 2013 Marzo | 8 | 5 | 13 |
| 2013 Febrero | 5 | 5 | 10 |
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