“The problem with melanoma, as with many other branches of contemporary clinical research, is that it is based on circumstantial evidence obtained from epidemiological studies rather than an understanding of the pathology. Melanoma is an illustration of the muddle introduced by uncritical acceptance of epidemiology with its almost random generation of unhelpful numbers.” — Dr. Sam Shuster, Emeritus Professor of Dermatology at the University of Newcastle Upon Tyne, and Honorary Consultant to the Department of Dermatology, Norfolk and Norwich University Hospital.

Shuster is one of a growing group of dermatology leaders to speak up against those who have based a connection between melanoma and UV exposure on poorly designed epidemiological studies that do not account for confounding factors without a real understanding of how UV would cause melanoma. “A preoccupation with epidemiology has distracted us from the essential biology. For example, we still need to establish the melanoma’s cell of origin. Many think it starts in the pigment cell, the melanocyte, but it may start in the ‘naevus’ cell of the ordinary ‘mole’. Establishing this is vital to our understanding because we know the distribution of moles but not naevus cells over the skin surface, let alone what makes them go malignant. It is well established that UV damage to DNA can produce cancer; but the only sensible conclusion from all the studies to date has to be that while this effect plays a major role in producing epitheliomas, at worst it can only be marginal for melanomas.”

To read Shuster’s essay, “The Skin Cancer Cover Up” click here.