***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Malignant melanoma has been one of the most rapidly increasing cancers within the United States with few modifiable risk factors . This study investigates risk related to dietary factors , which are potentially modifiable . METHODS Newly diagnosed patients with melanoma ( n = 502 ) were recruited from pigment lesion clinics and controls ( n = 565 ) were recruited from outpatient clinics . To investigate the relationship between melanoma and dietary factors in this case-control study , study subjects were requested to complete a food frequency question naire , which assessed diet over the previous year . Using logistic regression , odds ratios ( ORs ) for melanoma were computed for nutrient and alcohol intake . RESULTS Persons in high versus low quintiles of energy-adjusted vitamin D , alpha-carotene , beta-carotene , cryptoxanthin , lutein , and lycopene had significantly reduced risk for melanoma ( ORs < or = 0.67 ) , which remained after adjustment for presence of dysplastic nevi , education , and skin response to repeated sun exposure . Addition of micronutrients from supplements did not add an additional reduction in risk . High alcohol consumption was associated with an increased risk for melanoma , which remained after adjustment for confounders [ OR ( 95 % confidence interval ) in highest versus lowest quintiles , 1.65 ( 1.09 - 2.49 ) ] . CONCLUSIONS Diets consisting of foods rich in vitamin D and carotenoids and low in alcohol may be associated with a reduction in risk for melanoma . These analyses should be repeated in large , prospect i ve studies In a prospect i ve study of 102 patients with pre-neoplasia and /or manifest squamous-cell carcinoma of the lower lip the synchronous occurrence of intra-oral , pharyngeal or laryngeal leukoplakia and carcinoma was assessed . There was a coincidence rate of almost 15 % leukoplakias , including individual carcinomas . This high coincidence is probably due to a combination of various " risk profiles " in patients with threatened or manifest lower-lip cancer . Chronic exposure to sunlight , especially in the presence of a genetic disposition , is the most important risk factor in lower-lip cancer and its preceding stages , while chronic alcoholism and smoking abuse have little etiological significance We prospect ively investigated whether alcohol intake and smoking affect the risk of basal cell carcinoma ( BCC ) in subjects from the United States Radiological Technologists ( USRT ) cohort study . We evaluated 68,371 radiological technologists certified during 1926 - 1982 who were free of cancer at the time they answered a first question naire ( 1983 - 1989 ) and who completed a second question naire ( 1994 - 1998 ) . The first question naire provided baseline information on numerous risk factors , including smoking and alcohol intake , and the second provided self-reported cancer diagnoses . During 698,190 person-years of follow-up , we identified 1,360 cases of BCC : 1,036 in women and 324 in men . Cox proportional hazards regression indicated that the trend in BCC was significantly associated with increased alcohol intake ( P for trend = 0.001 ) . Compared with those who reported no alcohol consumption , those who drank < 1 - 2 , 3 - 6 , 7 - 14 , and > 14 drinks/week had multivariate risks of 1.1 [ 95 % confidence interval ( CI ) , 0.9 - 1.3 ] , 1.3 ( 95 % CI , 1.1 - 1.5 ) , 1.4 ( 95 % CI , 1.2 - 1.7 ) , and 1.0 ( 95 % CI , 0.7 - 1.6 ) , respectively . We found no clear association between smoking and BCC . This is the second large prospect i ve study to report a significant but nonmonotonic trend in increased risk associated with alcohol consumption The aim of this study was to identify factors related to  lip cancer ( LC ) considering individual characteristics and sociodemographic factors . A case – control study was carried out in the province of Granada ( And alusia , southern Spain ) . The cases were 105 males with squamous-cell carcinoma of the lip , diagnosed between 1987 and 1989 ( aged 20–70 years ) and identified by means of a population -based Cancer Registry . As controls , a r and omised population al sample of 239 males , stratified by age , was used . Multiple logistic regression analysis showed that risk factors are lifetime cumulative tobacco consumption and alcohol consumption . An interaction was found between alcohol consumption and the smoking habit ( leaving the cigarette on the lip ) : OR=23.6 ; 95 % CI : 3.9–142.0 . Other risk factors identified are clear eyes ( OR=3.5 ; CI : 95 % 1.5–8.0 ) , sun exposure early in life and cumulative sun exposure during outdoor work ( OR=11.9 ; 95 % : CI : 1.3–108.9 ) , and skin reaction to sun exposure ( Fitzpatrick levels ) . Another interaction was found between skin reaction and a previous history of common sporadic warts ( OR=4.4 ; 95 % CI : 1.01–19.1 ) . We conclude that LC is related to phenotype , skin reaction to sun exposure , cumulative and early sunlight exposure , and tobacco and alcohol consumption , as well as a low educational level . Leaving the cigarette on the lip is predictive of LC risk irrespective of cumulative tobacco consumption To determine the relationship between 25(OH ) vitamin D levels and non-melanoma skin cancer ( NMSC ) , we performed a nested case – control study in ambulatory , elderly men enrolled in the Osteoporotic Fractures in Men ( MrOS ) Study . Health habit and medical history , including self-reported history of NMSC were recorded and 25(OH)D levels were measured on serum collected at baseline from a r and om sample of Caucasian MrOS subjects .  Mean age ( 73 ± 5 ) , BMI , daily vitamin D and calcium intake were similar in the men with ( n = 178 ) and without NMSC ( n = 930 ) , but higher levels of 25(OH)D were associated with a decreased risk of having a history of NMSC ( Ptrend = 0.04 ) . Men in the highest quintile of 25(OH)D ( > 30 ng/mL ) had 47 % lower odds of NMSC ( 95 % CI : 0.30–0.93 , p = 0.026 ) compared to those in the lowest quintile . Our results suggest that a diagnosis of NMSC is not a surrogate for adequate 25(OH)D levels or increased UV exposure , and high 25(OH)D levels may be associated with a reduced risk of NMSC OBJECTIVES This study evaluated the influence of occupational exposure on cancer risk among female Norwegian nurses . METHODS A historical prospect i ve cohort study was performed . The cohort was established from the Norwegian Board of Health 's registry of nurses and included women who graduated from a nursing school before 1985 . The cohort ( N=43 316 ) was linked to the Cancer Registry of Norway . The observed number of cases was compared with the expected number on the basis of national rates . Time since first employment , period of first employment , and duration of employment were used as indicators of exposure . Poisson regression analyses were used for internal comparisons , adjusting for age , period , and fertility . RESULTS The nurses were followed over 1473931 person-years . During the follow-up ( 1953 - 2002 ) , 6193 cancer cases were observed . The st and ardized incidence ratio ( SIR ) for all cancers combined was close to unity . Significantly lower risks were found for cancers with a known association with alcohol and tobacco consumption and sexual activity . A significantly increased risk was found for breast cancer ( SIR 1.14 , 95 % confidence interval ( 95 % CI ) 1.09 - 1.19 ) , ovarian cancer ( SIR 1.14 , 95 % CI 1.04 - 1.25 ) , malignant melanoma ( SIR 1.15 , 95 % CI 1.04 - 1.28 ) , and borderline significant risk appeared for other skin cancer ( SIR 1.12 , 95 % CI 0.98 - 1.29 ) . A positive trend for increasing time since first exposure was found for breast cancer and malignant melanoma . CONCLUSIONS The results indicate an association between working as a nurse and an increased risk of breast cancer and malignant melanoma . Decreased risks , found for several cancers , indicate favorable lifestyle habits among nurses In a prospect i ve study of self-reported demographic , constitutional , and life-style factors in relation to basal cell carcinoma of the skin , we followed a cohort of 73,366 nurses in the United States who were 34 to 59 years of age in 1980 and who had no previous skin or other cancer . In 4 years of follow-up , compared with women living in the Northeast , women residing in California ( age-adjusted relative risk [ RR ] = 1.57 ; 95 % confidence interval [ CI ] = 1.30 to 1.89 ) and Florida ( RR = 2.12 ; 95 % CI = 1.54 to 2.92 ) were more likely to develop basal cell carcinoma . Compared with women having naturally dark brown hair , the age-adjusted relative risk of basal cell carcinoma was increased among women with red ( RR = 2.45 ; 95 % CI = 1.89 to 3.19 ) , blonde ( RR = 1.37 ; 95 % CI = 1.09 to 1.71 ) , or light brown hair ( RR = 1.27 ; 95 % CI = 1.08 to 1.49 ) and was decreased among women with black hair ( RR = 0.66 ; 95 % CI = 0.41 to 1.06 ) . Risk was positively associated in a dose-response manner both with tendency to sunburn as a child or adolescent and with lifetime number of severe and painful sunburns on the face or arms . These risk factors remained significant predictors of disease when included simultaneously in multivariate analyses . Tendency to tan was associated with decreased risk , although this risk was not significant after controlling for the other constitutional determinants and region . Cigarette smoking did not alter the risk of basal cell carcinoma . These prospect i ve data emphasize the importance of sunlight , and skin response to sunlight , as determinants of basal cell carcinoma among women Objective : To investigate the association between total alcohol intake and intake of different types of alcoholic beverages in relation to the risk of basal cell ( BCC ) and squamous cell ( SCC ) carcinoma of the skin . Design : Prospect i ve cohort study . Setting : Follow-up data from a community-based skin cancer study in Australia . Subjects : R and omly selected sample of 1360 adult residents of the township of Nambour who completed a food frequency question naire in 1992 and were monitored for BCC and SCC until 31 December 2002 . Results : No significant association was found between overall BCC or SCC risk and total alcohol intake  , or intake of beer , white wine , red wine or sherry and port . However , among those with a prior skin cancer history , there was a significant doubling of risk of SCC for above-median consumption of sherry and port ( multivariable adjusted relative risk 2.46 , 95 % confidence interval 1.06–5.72 ) compared with abstainers . Conclusions : There are no associations between first occurrence of skin cancers and alcoholic beverage consumption . People with a history of skin cancer who consume above-average quantities of sherry or port may be at a raised risk of SCC , although replication of these findings in different study population s is needed to confirm this possible role of specific alcoholic beverages in secondary keratinocytic skin cancer risk We prospect ively examined the intake of alcoholic beverages in relation to the  risk of basal cell carcinoma BCC in two large cohorts of men and women .  Alcohol intake was assessed with food frequency question naires every 2 - 4 years , and BCC was ascertained by self-report . We used a pooled logistic regression to model the association between alcohol intake and BCC adjusting for various health , sun exposure , and sun-sensitivity factors . During 8 years of follow-up in women ( 1986 - 1994 ) we recorded 3060 cases of BCC , and during 10 years ( 1986 - 1996 ) , we recorded 3028 cases in men . Significant positive associations were observed between  total alcohol intake  ( P for trend < 0.0001 ) ,  alcohol from liquor  ( P for trend = 0.003 ) , and  white wine  ( P for trend = 0.01 ) intake and risk of BCC . Compared with those who abstained , those who drank 0.1 - 4.9 g , 5.0 - 14.9 g , 15.0 - 14.9 g , and 30 g or more alcohol a day had multivariate relative risks of 1.11 [ 95 % confidence interval ( CI ) , 1.03 , 1.19 ] , 1.26 ( 95 % CI , 1.12 , 1.41 ) , 1.29 ( 95 % CI , 1.18 , 1.42 ) , and 
    Output:
    
This study clearly demonstrates that smoking increases the risk of cutaneous squamous cell carcinoma ; however , smoking does not appear to modify the risk of basal cell carcinoma