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Sunlamp use is a risk factor for uveal melanoma: a meta-analysis

Published:April 08, 2021DOI:https://doi.org/10.1016/j.jcjo.2021.02.041

      Abstract

      Objective

      Advancements in the treatment of uveal melanoma have not improved survival; therefore, identifying modifiable risk factors is critical to improving outcomes. This study aims to investigate the association between sunlamp use and the development of uveal melanoma.

      Design

      This study is designed as a meta-analysis.

      Methods

      Literature was searched and reviewed through the MEDLINE (with both OVID and PubMed), EMBASE, MD Consult, and Web of Science databases. These databases were searched from 1966 to 2019 using the following keywords to identify articles examining risk factors for uveal melanoma: ultraviolet, sun, sunlight, uveal melanoma, eye cancer, eye melanoma, nevus, and risk factor. All articles were evaluated for inclusion based on methodology and data reporting association between sunlamp use and uveal melanoma. The Meta-analysis of Observational Studies in Epidemiology guidelines and the Newcastle-Ottawa Scale were used to assess data quality and validity. A random effects model was employed.

      Results

      A total of 5 studies, enrolling a total of 1753 uveal melanoma cases and 3399 controls were included in this meta-analysis. The results of this study showed a positive association between sunlamp use and uveal melanoma (odds ratio = 2.15; 95% confidence interval 1.27–3.64). Meta-regression of between study heterogeneity did not reveal a statistically significant association when publication year, site latitude, melanoma tissue location (specifically, inclusion of iris tumors), or control type (population versus clinic) were evaluated.

      Conclusion

      This meta-analysis identified a statistically significant association between sunlamp use and uveal melanoma, supporting sunlamp use as a modifiable risk factor for uveal melanoma.

      Résumé

      Objectif

      Les progrès réalisés dans le traitement du mélanome uvéal n'ont pas permis d'améliorer le taux de survie; de ce fait, l'identification de facteurs de risque modifiables est essentielle à l'amélioration des résultats. La présente étude vise à examiner l'association entre l'utilisation de lampes solaires et l'apparition d'un mélanome de l'uvée.

      Nature

      Il s'agit d'une méta-analyse.

      Résultats

      On a procédé à un examen de différentes bases de données : MEDLINE (y compris OVID et PubMed), EMBASE, MD Consult et Web of Science. Les recherches ont porté sur les mots-clés suivants (termes anglais) afin d'identifier les articles sur les facteurs de risque du mélanome uvéal qui ont été publiés entre 1966 et 2019 : rayons ultraviolets, soleil, lumière du soleil, mélanome uvéal, cancer oculaire, mélanome oculaire, naevus et facteur de risque. Chaque article a été étudié en vue d’être inclus à la méta-analyse selon la méthodologie et la communication des données associant l'utilisation de lampes solaires et le mélanome de l'uvée. Les lignes directrices MOOSE (Meta-analysis of Observational Studies in Epidemiology) et l’échelle Newcastle-Ottawa ont servi à évaluer la qualité et la validité des données. On a utilisé un modèle à effets aléatoires.

      Résultats

      Au total, 5 études regroupant quelque 1753 cas de mélanome de l'uvée et 3399 sujets témoins ont été incluses dans cette méta-analyse. Les résultats font état d'une association positive entre l'utilisation de lampes solaires et le mélanome uvéal (rapport de cotes = 2,15; intervalle de confiance à 95 % = 1,27–3,64). La méta-régression analysant l'hétérogénéité entre les études n'a pas fait ressortir d'association statistiquement significative avec l'année de publication, la latitude du site de l’étude, la localisation tissulaire du mélanome (plus spécifiquement, l'inclusion des tumeurs de l'iris) ni le type de groupe témoin (population générale vs sujets atteints).

      Conclusion

      Notre méta-analyse a mis au jour une association statistiquement significative entre l'utilisation de lampes solaires et le mélanome uvéal, ce qui permet d'affirmer que l'utilisation de lampes solaires est un facteur de risque modifiable du mélanome de l'uvée.
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