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Re: Melanoma and dentist: only socioeconomic status?

To the Editor:

We have read the interesting paper from Adam Simning and Edwin van Wijngaarden about cancer in dentists. However, in their article, they attribute the increased skin cancer occurrence in this occupation to socioeconomic status.

In this sense, we would like to point out that, at least in Sweden, our results showed a significant risk excess of melanoma in males dentists [1] and female dental nurses [2] even after socioeconomic adjustment. Female dentists had also a non significant increase of risk. Higher incidences of melanoma than expected by chance for dentistry, in both men and women, have been found in pooled SIR of Nordic countries [3], in England and Wales [4], but also in socioeconomic adjusted estimators for men in US [5] and Switzerland, [6]. Dentists are exposed to certain agents that have been related to this neoplasm, such as artificial sources of UV radiation[7] and/or mercury[8]. Thus, occupational explanations for this possible excess should also be kept in mind

1 Perez-Gomez B, Pollan M, Gustavsson P, et al. Cutaneous melanoma: hints from occupational risks by anatomic site in Swedish men. Occup Environ Med 2004;61:117-26.

2 Perez-Gomez B, Aragones N, Gustavsson P, et al. Cutaneous melanoma in Swedish women: Occupational risks by anatomic site. Am J Ind Med 2005;48 (4):270-81.

3 Andersen A, Barlow L, Engeland A, et al. Work-related cancer in the Nordic countries. Scand J Work Environ Health 1999;25 (Suppl 2):1-116.

4 Vagero D, Swerdlow AJ, Beral V. Occupation and malignant melanoma: a study based on cancer registration data in England and Wales and in Sweden. Br J Ind Med 1990;47 (5):317-24.

5 Goodman KJ, Bible ML, London S, et al. Proportional melanoma incidence and occupation among white males in Los Angeles County (California, United States). Cancer Causes Control 1995;6 (5):451-9.

6 Bouchardy C, Schuler G, Minder C, et al. Cancer risk by occupation and socioeconomic group among men--a study by the Association of Swiss Cancer Registries. Scand J Work Environ Health 2002;28 (Suppl 1):1-88.

7 Westerdahl J, Ingvar C, Masback A, et al. Risk of cutaneous malignant melanoma in relation to use of sunbeds: further evidence for UV- A carcinogenicity. Br J Cancer 2000;82 (9):1593-9.

8 Magnani C, Coggon D, Osmond C, et al. Occupation and five cancers: a case-control study using death certificates. Br J Ind Med 1987;44 (11):769-76.