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Objective:The low melanin production (depigmentation) evolved from low ultraviolet radiation may be the principal determinant of malignant melanoma of skin (C43).Design:Country-specific estimates of C43 incidence, daily UVR exposure, skin colour (EEL), socioeconomic status (GDP PPP), magnitude of reduced natural selection (Ibs), ageing, urbanization, percentage of European descendants (Eu%), and depigmentation measured by blonde hair colour, were subjected to statistical analyses. Data were derived from WHO, United Nations, World Bank databases and the literature.Setting:Ecological analysisParticipants:182 individual countries.Main outcome measures:Parametric and non-parametric correlations, partial correlation analyses keeping confounders statistically constant, multivariate regressions and analyses of variance.Results:Worldwide, UVR exposure was in negative correlation with C43 (“rho” = -0.515, p bs, ageing and urbanization were statistically kept constant.In stepwise linear regression analysis, UVR was the variable having greatest negative influence on C43 incidence (R2=0.301).Worldwide, C43 incidence was in strong correlation with Eu% (r = 0.711, p C43 incidence may not be attributable to UVR exposure. Low melanin production, genetically determined, that has adaptively evolved over generations represents an ultimate risk factor for C43. |
