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Purpose: Cutaneous melanoma is among the fastest growing malignancies in Norway and ultraviolet radiation (UVR) exposure is the primary environmental risk factor. Immunomodulating drugs can increase skin photosensitivity and suppress immune responses, and by such mechanisms influence melanoma risk. We, therefore, aimed to examine the associations between use of immunomodulating drugs and melanoma risk, at a nationwide population level. Patients and Methods: In the Cancer Registry of Norway, we identified all cases aged 18– 85 with a first primary cutaneous melanoma diagnosed in 2007– 2015 (n=12,106). These were matched to population controls from the Norwegian National Registry 1:10 (n=118,564), on sex and year of birth using risk set sampling. Information on prescribed drugs (2004– 2015) was obtained by linkage to the Norwegian Prescription Database (NorPD). Conditional logistic regression was used to estimate rate ratios (RRs) and 95% confidence intervals (CIs) for associations between use of immunomodulating drugs (immunosuppressants and corticosteroids) and melanoma risk, adjusted for ambient UVR and other drug use. Results: Compared with ≤ 1 prescription, use of ≥ 8 prescriptions of immunosuppressants was associated with increased risk of melanoma (RR 1.50, 95% CI 1.27, 1.77). Similar associations were found for subgroups of immunosuppressants: drugs typically prescribed to organ transplant recipients (OTRs) (RR 2.02, 95% CI 1.35, 3.03) and methotrexate (RR 1.27, 95% CI 1.04, 1.55). Similar results were found for high levels of cumulative doses and across all histological subtypes. Use of corticosteroids was not associated with melanoma risk. Conclusion: We found a positive association between use of immunosuppressants and melanoma risk, with the highest risk seen for drugs prescribed to OTRs. Knowledge about this risk increase is important for physicians and users of these drugs, for intensified surveillance, awareness and cautious sun exposure. [ABSTRACT FROM AUTHOR]

Purpose: Melanoma is the cancer with the most rapidly rising incidence rate in Norway. Although exposure to ultraviolet radiation (UVR) is the major environmental risk factor, other factors may also contribute. Antidepressants have cancer inhibiting and promoting side effects, and their prescription rates have increased in parallel with melanoma incidence. Thus, we aimed to prospectively examine the association between use of antidepressants and melanoma by using nation-wide data from the Cancer Registry of Norway, the National Registry, the Norwegian Prescription Database and the Medical Birth Registry of Norway. Patient and Methods: All cases aged 18– 85 with a primary cutaneous invasive melanoma diagnosed during 2007– 2015 (n=12,099) were matched to population controls 1:10 (n=118,467) by sex and year of birth using risk-set sampling. We obtained information on prescribed antidepressants and other potentially confounding drug use (2004– 2015). Conditional logistic regression was used to estimate adjusted rate ratios (RRs) and 95% confidence intervals (CIs) for the association between overall and class-specific use of antidepressants and incident melanoma. Results: Compared with ≤ 1 prescription, ≥ 8 prescriptions of antidepressants overall were negatively associated with melanoma (RR 0.81 CI 0.75– 0.87). Class-specific analyses showed decreased RRs for selective serotonin reuptake inhibitors (RR 0.82 CI 0.73– 0.93) and mixed antidepressants (RR 0.77 CI 0.69– 0.86). The negative association was found for both sexes, age ≥ 50 years, residential regions with medium and highest ambient UVR exposure, all histological subtypes, trunk, upper and lower limb sites and local disease. Conclusion: Use of antidepressants was associated with decreased risk of melanoma. There are at least two possible explanations for our results; cancer-inhibiting actions induced by the drug and less UVR exposure among the most frequent users of antidepressants. [ABSTRACT FROM AUTHOR]

Numerous epidemiological studies have shown associations between increases in outdoor air pollution and all-cause mortality as well as cardiovascular and respiratory related mortality. The majority of studies has used the routine monitoring network and thus has not been able to characterize the small-scale variation in daily averages and peak concentrations within urban settings. To address possible short term impact on mortally by air pollution we used a time-stratified case-crossover design to estimate associations of traffic-related air pollution and wood burning and daily mortality during a period of 10 years among residents above 50 years of age in Oslo, Norway. A dispersion model was used to assess short-term air pollution for daily (24-h) averages and peak concentrations of nitrogen dioxide (NO) from exhaust and particulate matter with a diameter of 2.5 μm or less (PM) from exhaust and wood-burning at residential neighbourhood level for each individual. We found an overall increased risk from exposure at the lag of 0-5 days before the day of death for both pollutants. The excess risk was highest for PM with a 2.8 % (95 % confidence interval: 1.2-4.4) increase per 10 μg per cubic meter change in daily exposure. Short-term traffic-related air pollution was associated with increased risk for mortality among individuals above 50 years of age, especially for circulatory outcomes. [ABSTRACT FROM AUTHOR]