Post hoc analysis of a large US population-based study of melanoma was carried out to test Whitemans divergent pathway model that suggests different etiologic pathways for melanoma based on (1) pattern of sun exposure, as characterized by anatomic site, and (2) host factors such as propensity for melanocyte proliferation, as characterized by nevus status. Study subjects consisted of 528 newly diagnosed cases of melanoma among Caucasian residents of Connecticut. Nurse-interviewers obtained information on age, gender, hair color, eye color, skin color, history of sun exposure, history of painful sunburns, anatomic site of melanoma, and number of nevi on both arms and the back. Age-adjusted simultaneous odds ratios with 95% confidence intervals were generated using nevus status as the dependent variable. The study found a statistically significant relationship (p<0.01) exists between anatomic site of melanoma and having many nevi. This is consistent with the prediction of the divergent pathway model for different paths to melanoma formation based on pattern of sun exposure and host propensity for melanocyte proliferation. Further investigation into the biological basis for the divergent pathway is warranted so that skin cancer prevention strategies can be tailored to specific populations.'
Kunkel, David; Dan Tandberg; and Marianne Berwick. "Testing the Divergent Pathway Model for Melanoma." (2008). http://digitalrepository.unm.edu/ume-research-papers/15