03b94b86-3d51-4507-8fa2-fe337d186e02.json

{
 "id": "03b94b86-3d51-4507-8fa2-fe337d186e02",
 "disease": {
  "id": "H00038",
  "names": [
   "Melanoma"
  ],
  "dbLinks": {
   "icd10": [
    "C43"
   ],
   "mesh": [
    "D008545"
   ]
  },
  "category": "Cancer",
  "description": "Melanoma is a form of skin cancer that has a poor prognosis and which is on the rise in Western populations. Melanoma arises from the malignant transformation of pigment-producing cells, melanocytes. The only known environmental risk factor is exposure to ultraviolet (UV) light and in people with fair skin the risk is greatly increased. Melanoma pathogenesis is also driven by genetic factors. Oncogenic NRAS mutations activate both effector pathways Raf-MEK-ERK and PI3K-Akt. The Raf-MEK-ERK pathway may also be activated via mutations in the BRAF gene. The PI3K-Akt pathway may be activated through loss or mutation of the inhibitory tumor suppressor gene PTEN. These mutations arise early during melanoma pathogenesis and are preserved throughout tumor progression. Melanoma development has been shown to be strongly associated with inactivation of the p16INK4a/cyclin dependent kinases 4 and 6/retinoblastoma protein (p16INK4a/CDK4,6/pRb) and p14ARF/human double minute 2/p53 (p14ARF/HMD2/p53) tumor suppressor pathways. MITF and TP53 are implicated in further melanoma progression."
 },
 "article": {
  "id": "24876226",
  "text": "BACKGROUND:\nFew prospective studies have examined the relationship between sun exposure, other potential risk factors, and risk of different skin cancers [including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma] simultaneously.\n\nMETHODS:\nWe evaluated the association between a number of potential risk factors and skin cancer risk in a cohort of 108,916 US women, the Nurses' Health Study II (1989-2009).\n\nRESULTS:\nDuring 2.05 million years of follow-up, we identified 6,955, 880, and 779 diagnoses of BCC, SCC, and melanoma, respectively. Compared with participants in the lowest quintile of cumulative ultraviolet flux in adulthood, participants in the highest quintile had multivariable-adjusted relative risks (RR) of 2.35 (Ptrend \u003c 0.0001) for BCC, 2.53 (Ptrend = 0.009) for SCC, and 0.68 (Ptrend = 0.38) for melanoma. In contrast, the RRs were 1.68 (95% CI, 1.55-1.82) for BCC, 1.68 (95% CI, 1.34-2.11) for SCC, and 1.80 (95% CI, 1.42-2.28) for melanoma for participants with ≥5 blistering sunburns when compared with participants without sunburn between ages 15 and 20 years. We found significant interactions between family history of melanoma, number of blistering sunburns between ages 15 and 20 years and BCC risk, and between sunburn reaction as a child/adolescent and SCC risk (all Pinteraction \u003c 0.05).\n\nCONCLUSION:\nIn a cohort of U.S. women, we found that sun exposures in both early life and adulthood were predictive of BCC and SCC risks, whereas melanoma risk was predominantly associated with sun exposure in early life.\n\nIMPACT:\nOur results may have potential implications for the prevention of skin cancers. Cancer Epidemiol Biomarkers Prev; 23(6); 1080-9. ©2014 AACR."
 },
 "questions": [
  {
   "id": "f66e889f-0816-4ea9-a296-fef0b984d9d2",
   "text": "What are the risk factors of Melanoma?",
   "answers": [
    {
     "answer_start": 1008,
     "text": "≥5 blistering sunburns"
    },
    {
     "answer_start": 1151,
     "text": "family history of melanoma"
    },
    {
     "answer_start": 1179,
     "text": "number of blistering sunburns between ages 15 and 20 years"
    }
   ]
  }
 ]
}