Factors in early adolescence associated with a mole-prone phenotype in late adolescence Journal Article


Authors: Xu, H.; Marchetti, M. A.; Dusza, S. W.; Chung, E.; Fonseca, M.; Scope, A.; Geller, A. C.; Bishop, M.; Marghoob, A. A.; Halpern, A. C.
Article Title: Factors in early adolescence associated with a mole-prone phenotype in late adolescence
Abstract: IMPORTANCE: Nevi are important phenotypic risk factors for melanoma in adults. Few studies have examined the constitutional and behavioral factors associated with a mole-prone phenotype in adolescents. OBJECTIVE: To identify host, behavioral, and dermoscopic factors in early adolescence (age, 14 years) that are associated with a mole-prone phenotype in late adolescence (age, 17 years). DESIGN, SETTING, AND PARTICIPANTS: A prospective observational cohort study from the Study of Nevi in Children was conducted from January 1, 2009, to December 31, 2014, with a 2- to 3-year follow-up. A total of 569 students from the school system in Framingham, Massachusetts, were enrolled in the 8th or 9th grade (baseline; mean [SD] age, 14.4 [0.7] years). The overall retention rate was 73.3%, and 417 students were reassessed in the 11th grade. MAIN OUTCOME AND MEASURES: Mole-prone phenotype in the 11th grade, defined as total nevus count of the back and 1 randomly selected leg in the top decile of the cohort or having any nevi greater than 5 mm in diameter. RESULTS: Of the 417 students assessed at follow-up in the 11th grade (166 females and 251 males; mean [SD] age, 17.0 [0.4] years), 111 participants (26.6%) demonstrated a mole-prone phenotype: 69 students (62.2%) with 1 nevus greater than 5 mm in diameter, 23 students (20.7%) with total nevus count in the top decile, and 19 students (17.1%) with both characteristics. On multivariate analysis, baseline total nevus count (adjusted odds ratio, 9.08; 95% CI, 4.0-23.7; P < .001) and increased variability of nevus dermoscopic pattern (adjusted odds ratio, 4.24; 95% CI, 1.36-13.25; P = .01) were associated with a mole-prone phenotype. CONCLUSIONS AND RELEVANCE: This study found clinically recognizable factors associated with a mole-prone phenotype that may facilitate the identification of individuals at risk for melanoma. These findings could have implications for primary prevention strategies and help target at-risk adolescents for higher-intensity counseling about sun protection and skin self-examination. © 2017 American Medical Association. All rights reserved.
Keywords: adolescent; major clinical study; cancer risk; follow up; follow-up studies; prospective study; prospective studies; phenotype; melanoma; cohort studies; dermoscopy; sun exposure; nevus; skin neoplasms; cohort analysis; risk factors; risk factor; epiluminescence microscopy; risk assessment; multivariate analysis; observational study; disease predisposition; longitudinal study; sunburn; student; massachusetts; adolescence; students; summer; procedures; humans; human; male; female; priority journal; article
Journal Title: JAMA Dermatology
Volume: 153
Issue: 10
ISSN: 2168-6068
Publisher: American Medical Association  
Date Published: 2017-10-01
Start Page: 990
End Page: 998
Language: English
DOI: 10.1001/jamadermatol.2017.1547
PUBMED: 28593303
PROVIDER: scopus
PMCID: PMC5638685
DOI/URL:
Notes: Article -- Export Date: 2 November 2017 -- Source: Scopus
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MSK Authors
  1. Esther Chung
    3 Chung
  2. Allan C Halpern
    283 Halpern
  3. Stephen Dusza
    144 Dusza
  4. Alon Scope
    110 Scope
  5. Ashfaq A Marghoob
    352 Marghoob
  6. Maira   Fonseca
    11 Fonseca
  7. Haoming Xu
    7 Xu