Patients' perception of the cause of their melanoma differs from that of epidemiologists

Sir, Exposure to sunlight is considered the major environmental cause of melanoma.1 In Europe, 80% of melanomas may have been caused by ultraviolet (UV) radiation; the significance of intermittent periods of intensive exposure to UV radiation as a child, sometimes reflected by a history of sunburns during childhood, seems unequivocal.2, 3 We report here on patient perception of the cause of melanoma, based on 69 Dutch patients, aged 19–50 years, who were diagnosed with melanoma in 1998–2000 and participated in a European study on sunbed use and melanoma risk. Before the interview, they received a leaflet stating that exposure to UV radiation is an important risk factor for melanoma. During a face‐to‐face interview, they answered questions regarding sunbathing habits since their youth, including sunbed use. At the end of the interview, they were asked about their perception of the cause of their melanoma. Sixty‐three (91%) of patients responded, 25 males and 38 females, with a median age of 39 (19–50) years. Their answers are listed in Table 1, according to sunburn experience, skin type, anatomical site and level of education, respectively. One‐third of the respondents mentioned exposure to the sun as a possible cause of their melanoma; 12 of 63 (19%) were quite certain that exposure to the sun was the cause of their melanoma, seven (11%) blamed sunbed use and 10 more (16%) did not exclude the possibility that exposure to UV radiation was the cause of their melanoma (Table 1). Males attributed their melanoma directly to the sun or sunbeds more often (32%) than females (22%).