Document Type


Publication Date


Publication Title

BMJ Open


Geisel School of Medicine


Introduction The incidence and mortality rates of

cutaneous melanoma (CM) are increasing among fai skinned populations worldwide. Ultraviolet radiation s the principal risk factor for CM, but is also the mai source of 25-hydroxyvitamin D (25(OH)D), which has associated with reduced risk and better prognosis of cancer types. However, both low and high 25(OH)D l have been associated with increased risk of CM. Obe as measured by body mass index (BMI) is associated risk of several cancers and has also been suggested risk factor for CM, and may also be related to insuffi 25(OH)D and/or high leptin levels. Moreover, contract CM diagnosis has been associated with increased ri developing second cancer. We aim to study whether prediagnostic serum levels of 25(OH)D, high prediag evels of BMI and high serum leptin levels influence ncidence, Breslow thickness and CM mortality, and second cancer and survival after a CM diagnosis.

Methods and analysis Cohort and nested case–co studies will be carried out using the population-base Janus Serum Bank Cohort (archival prediagnostic se BMI, smoking and physical activity), with follow-up fr 1972 to 2014. Additional data will be received from t Cancer Registry of Norway, the national Cause of De Registry, Statistics Norway (education and occupatio and exposure matrices of UVR. Time-to-event regres models will be used to analyse the cohort data, whil he nested case–control studies will be analysed by conditional logistic regression. A multilevel approach be applied when incorporating group-level data.

Ethics and dissemination The project is approved he Regional Committee for Medical Research Ethics and is funded by the Norwegian Cancer Society. Res will be published in peer-reviewed journals, at scient conferences and in the news media.



Included in

Oncology Commons