Results from a systematic review suggest that UV exposure might not be a risk factor for melanoma development in individuals with skin of color.1 These findings were published in JAMA Dermatology.

Though existing evidence identifies UV exposure as a risk factor for cutaneous melanoma in fair-skinned populations, the strength of the association has been less certain in darker-skinned populations.

Therefore, the authors of this analysis sought to characterize the clinical relationship between UV exposure and skin of color. Notably, transplant recipients, immunosuppressed people, and individuals with potentially significantly elevated melanoma risk were excluded from the evaluation.

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The systematic review included 13 studies that assessed UV exposure as a risk factor for cutaneous melanoma in people with skin of color. This included 7 ecological studies, 5 cohort studies, and 1 case-control study encompassing more than 7,700 melanomas in individuals with skin of color.

Of these 13 studies, 11 found no association between UV exposure and melanoma in skin of color. Only 1 study showed a small positive relationship in Black men, and 1 showed a weak association in Hispanic men.

A quality assessment demonstrated that all of the included studies had moderate to low quality evidence based on study design, indicating that further study is needed to “fully elucidate this association,” according to the researchers.

Study limitations included the difficulty of quantifying UV exposure, which complicated cross-study comparison. Further, exposure to UV and melanoma outcomes could have been separated by long periods of time that might not have been noted in the studies with short follow-up.

The study authors concluded that the data “suggest that UV exposure is not an important risk factor for melanoma development in skin of color” and “question the notion that patients with skin of color should practice UV protection to reduce their risk for melanoma.” Further research is necessary to identify melanoma risk factors in populations with skin of color, which could translate to improved patient outcomes and a reduction in associated health disparities, they added.

Disclosures: Some of the study authors disclosed financial relationships with the pharmaceutical industry and/or the medical device industry. For a full list of disclosures, please refer to the original study.


Lopes FCPS, Sleiman MG, Sebastian K, et al. UV exposure and the risk of cutaneous melanoma in skin of color. A systematic review. JAMA Dermatol. Published online December 16, 2020. doi:10.1001/jamadermatol.2020.4616