Melanoma & Keratinocyte Skin Cancer

Divergent causal pathways to melanoma: a combined analysis of 12 case-control studies

Exploring the causal pathways to cutaneous melanoma

Xstrata Post-doctoral Fellowship in Melanoma Research

20 Year Study of Skin Cancer in a Queensland Community

The association between Human Papilloma Virus (HPV) and Squamous Cell Carcinoma (SCC) of the Skin

Divergent causal pathways to melanoma: a combined analysis of 12 case-control studies
Funded by the US National Cancer Institute 1R03CA132188-01
D Whiteman, A Green, C Olsen, T Stukel (Toronto, Canada), M Karagas (Dartmouth, USA)
Melanomas are common cancers arising from the pigment cells of the skin. Each year, more than 62,000 people are diagnosed with invasive melanoma in the United States, resulting in almost 8,000 deaths annually. Sunlight is the principal factor that causes melanoma, although there is increasing evidence that the role of sunlight in causing melanoma is not the same for all people.

We have recently proposed a "divergent pathway" hypothesis for the development of melanoma. Under this model, we posit that people who are prone to develop nevi (moles) are at higher-than-average risk for melanoma. We hypothesize that such people will develop melanoma after modest amounts of sun exposure, and will do so on body sites with large populations of pigment cells such as the back. In contrast, other people who are less prone to developing nevi require exposure to large cumulative doses of sunlight to develop melanoma, and these melanomas will tend to arise on habitually sun-exposed body sites such as the head and neck. Epidemiologic and molecular evidence in support of this hypothesis has been published based on analyses of small datasets.

This new project aims to test the divergent pathway hypothesis for the development of melanoma by undertaking a systematic re-analysis of the original study data collected from 12 case-control studies comprising individual data records for 2,954 people with melanoma and 3,685 healthy controls. The primary objective is to compare patients with melanomas arising at different body sites (trunk, head & neck, upper limb, lower limb) with melanoma-free controls to determine whether the distribution of nevi and sun exposure differs among the groups. When complete, this study will provide new information about the causes of melanoma. Such knowledge is crucial to controlling and preventing this cancer.

Exploring the causal pathways to cutaneous melanoma
D Whiteman, A Green
Funded by the National Health and Medical Research Council 2007-2011 Melanomas are cancers arising from the pigment cells of the skin, and are among the most commonly occurring cancers in this country. Each year, more than 8000 Australians are diagnosed with invasive melanoma, resulting in some 900 deaths annually. Sunlight is the principal factor which causes this disease, although there is increasing evidence that the role of sunlight in causing melanoma is not the same for all people who develop this disease. A new hypothesis proposes that the malignant course of melanomas may reflect their causal origins, with melanomas induced by chronic sunlight exposure perhaps being more aggressive than other melanomas. We will undertake a large study of patients with melanoma to investigate both the causal pathways to melanoma and their influence on markers of tumour aggressiveness. We will capture detailed information about the microscopic appearance of the melanomas from pathologists at the time of diagnosis, and marry this to the information reported by the patients about their past history of sun exposure. When complete, this study will provide new information about the causes of melanoma. Such knowledge is crucial to controlling and preventing this cancer.

Xstrata Post-doctoral Fellowship in Melanoma Research
D Whiteman
The Xstrata Post-doctoral Fellowship in Melanoma and Skin Cancer Research is a 3-year award to provide an outstanding training opportunity for a high-calibre researcher at an early stage of their career. The Xstrata Post-doctoral Fellow will work within the internationally renowned Cancer and Population Studies Group at QIMR to develop risk prediction tools for melanoma and other cancers of the skin, drawing upon the large datasets and analytical expertise of the Chief Investigators in the group.

20 Year Study of Skin Cancer in a Queensland Community
Funded by the National Health and Medical Research Council 2007-2009
A Green, G Williams, J van der Pols, P Valery, R Neale with P Parsons, G Boyle, P Scuffham (Griffith Uni)
Funded by the National Health and Medical Research Council 2007-2009 The keratinocyte skin cancers, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) together constitute around half of all cancers diagnosed in Australia: a greater burden on public health than anywhere else in the world. Excessive sun exposure is the predominant cause but differences in the causal pathways for each major type of skin cancer are still not understood. Relative intensity and dose of causal sun exposure vary and perhaps timing with respect to the life-course as well. By developing and integrating epidemiological and laboratory evidence collected over a 20 year period in a community-based skin cancer study, the Nambour Skin Cancer Study, this project aims to definitively clarify skin cancer aetiology and therefore prevention measures. In addition we aim to provide rarely available cost estimates of skin cancer in this community sample.

Dietary Factors and Actinic Skin Damage
A Green, M. Hughes in collaboration with A Fourtanier (L'Oreal) G Williams, G Marks (Uni of Qld)
We aim to examine in detail the associations between diet and skin photodamage using extensive dietary data collected in the Nambour Skin Cancer Prevention Trial (1992-1996) and 2006. Diet will be examined in two parallel arms, namely nutrient and supplement analyses; and particular food/food group analyses chosen to reflect levels of biologically active food factors (phenols, isoflavins, etc) in relation to risk of solar keratoses and photoageing.

The association between Human Papilloma Virus (HPV) and Squamous Cell Carcinoma (SCC) of the Skin
R. Neale, A. Green, in collaboration with with S.Harrison and P Beuttner (James Cook University and ) M Feltkamp, J ter Schegget, J-N Bouwes Bavinck et al (Academic Medical Centre, Leiden, The Netherlands & other European investigators
The hypothesis that HPV infection is associated with squamous cell carcinoma of the skin is being tested as firm evidence that HPV is associated with skin cancer would have far-reaching implications for skin cancer control, and would potentially result in substantial economic benefits to white-skinned populations, particularly in Australia. We are part of a large collaborative study framework using a variety of approaches to examine HPV and skin cancer status in people who have had a kidney transplant and are taking immunosupressive drugs, as well as in those whose immune systems are not being compromised in this way. The hair and blood samples that have been collected from patients in Australia are being analysed for the presence or absence of specific types of HPV by our European collaborators.