Oxford American handbook of oncology. Second Edition. Oxford University Press (2015)
- Epidemiological evidence suggests >90% of malignant melanoma is attributable to solar radiation.
- The most frequent primary sites are areas exposed intermittently but intensely, e.g., skin of the back.
- Australians who are mostly white and intensely exposed to UV radiation have the highest incidence of melanoma in the world, although recent declines have been reported.
- Rates of melanoma, however, continue to increase in the United States.
- Sun exposure, especially repeated burns in childhood, is a particular risk factor.
- Exposure to solar radiation is also associated with most nonmelanoma skin cancer.
- Basal cell and squamous cell carcinomas are associated with cumulative sun exposure, typically in maximally sun-exposed areas, e.g., the face and ears.