Abstract
Physical activity (PA) is an important factor in cancer prevention, but positive association between PA and risk of cutaneous melanoma found in recent studies may complicate this strategy. Ultraviolet radiation (UVR) exposure during outdoor PA is a plausible explanation for a positive association. We investigated the associations between PA, UVR and melanoma risk in the Norwegian Women and Cancer cohort. Overall PA was reported by 151,710 women, aged 30–75 at inclusion, using a validated 10-point-scale at enrolment and during follow-up, together with recent numbers of sunburns, indoor tanning sessions and weeks on sunbathing vacations. Seasonal outdoor walking and seasonal PAs were recorded in subsamples (n = 102,671 and n = 29,077, respectively). Logistic and Cox regression were used. Mean follow-up was 18.5 years, and 1565 invasive incident melanoma cases were diagnosed. Overall PA was inversely associated with sunburns, while positively associated with sunbathing vacations and indoor tanning. Overall PA was not associated with melanoma risk in all body sites combined (ptrend = 0.61), but reduced risk was found in upper limb melanomas (hazard ratio (HR) = 0.70, 95% confidence interval (CI) 0.51–0.96; high versus low PA). Non-significant reduced risks were found for seasonal outdoor walking >2 h/day versus 30–60 min/day (summer HR = 0.81, 95% CI 0.66–1.00; autumn HR = 0.74, 95%CI 0.55–1.01). Seasonal PAs were not associated with melanoma risk. In conclusion, we found positive associations between overall PA and sunbathing vacations and indoor tanning, and, unlike literature, inverse association between overall PA and sunburns. Our results do not support a positive association between PA and melanoma risk in Norwegian women.
Highlights
Incidence of cutaneous melanoma has been rising in fair-skinned populations during the past decades (Whiteman et al, 2016)
This study aimed at examining the relationship between Physical activity (PA), ultraviolet radiation (UVR) exposure and risk of melanoma in women using data from the Norwe gian Women and Cancer (NOWAC) study, a large, well-characterized population-based cohort with information on PA and UVR exposure updated during follow-up
We investigated the associations between PA, patterns and level of UVR exposure and melanoma risk in a large Norwegian prospective fe male cohort with comprehensive data on UVR exposure and up to three assessments of PA: overall PA, seasonal outdoor walking and seasonal PAs
Summary
Incidence of cutaneous melanoma (hereafter, melanoma) has been rising in fair-skinned populations during the past decades (Whiteman et al, 2016). More over, an absence (Moore et al, 2016; Behrens et al, 2018; Robsahm et al, 2017; Parent et al, 2011) or a broad assessment (Lee et al, 2009; Gogas et al, 2008; Veierod et al, 1997; Shors et al, 2001) of ultraviolet radiation (UVR) exposure might explain differences. UVR during outdoor PA is a plausible explanation for a positive association between PA and melanoma risk
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