4. WHAT ARE THE RISK FACTORS FOR MELANOMA?

a) Sun exposure; Exposure to the sun and other forms of radiation, including artificial radiation from tanning salons, has been linked to increased rates of melanoma. It is considered that excess sun exposure during childhood, particularly getting burnt to the point of blistering, is strongly linked to the development of melanoma later in life. However, while sun exposure is the most controllable and most strongly linked environmental factor to the development of melanoma, it should be noted that melanomas develop in individuals rarely exposed to the sun and in places rarely exposed to sunlight. This suggests that sun exposure is not the only cause of melanoma and that all individuals should take note of any potential warning signs of melanoma.

b) Presence of moles (nevus); An increased presence of moles or naevi, which are benign tumours, is associated with an increased risk of developing a melanoma the development of melanoma. Of particular concern are moles that may act as precursors to melanoma. These are known as atypical or dysplastic (unusual appearing) moles and congenital moles (brown birth marks) which carry a greater risk of developing into melanoma7. The flat naevi are of concern especially those that change in appearance, are irregular in shape, become itchy or ulcerated and/or change colour.

c) Age; Melanoma affects both the young and the elderly with most patients being diagnosed in their forties or fifties8. While this is the case there is still a higher incidence rate of melanoma in older individuals9. Indicating that age is an important risk factor. Furthermore, melanoma is rare in children below the age of twelve or before puberty, however, it is not unheard of and therefore everyone should take appropriate precautions8.

d) Heredity predisposition; Heredity predisposition may increase a persons risk of melanoma in the following ways:

• Family or personal history; Persons with a family or personal history of melanoma or non-melanoma skin cancer have an increased chance of developing melanomas. Persons with a heredity predisposition to melanoma are more likely to develop melanoma at a younger age and have multiple sites of melanoma7.
• Inherited conditions; Some inherited diseases also increase the risk of developing melanoma. For example, rare inherited disease Xeroderma Pigmentosum have a greater chance of getting skin cancer as their skin is less able to repair the damage caused by sunlight7.
• Reduced levels of Melanin; Having a fair complexion, blue eyes or red or blond hair are all factors associated with lower levels of melanin; a substance which helps protects your skin from the damaging effects of UV rays. Therefore, people with these characteristics may have an increased risk of developing melanoma7.

e) Immunosuppression or a poorly functioning immune system; A poorly functioning immune system increases the risk of many cancers including melanoma. There are many factors associated with immunosuppression, including viruses like HIV and Hepatitis and certain medications given for organ transplants, neuromuscular disorders and other medical conditions. Furthermore, poor nutrition and feeling emotionally depressed over time can lead to immunosuppression7,10.

f) Environmental irritates; Environmental irritates are associated with an increased risk of developing many cancers. For melanoma such irritates might include; radiation, chemicals known as carcinogens and trauma10.