Factors in early adolescence associated with a mole-prone phenotype in late adolescence

Haoming Xu, Michael A. Marchetti, Stephen W. Dusza, Esther Chung, Maira Fonseca, Alon Scope, Alan C. Geller, Marilyn Bishop, Ashfaq A. Marghoob, Allan C. Halpern*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


IMPORTANCE: Nevi are important phenotypic risk factors for melanoma in adults. Few studies have examined the constitutional and behavioral factors associated with a mole-prone phenotype in adolescents. OBJECTIVE: To identify host, behavioral, and dermoscopic factors in early adolescence (age, 14 years) that are associated with a mole-prone phenotype in late adolescence (age, 17 years). DESIGN, SETTING, AND PARTICIPANTS: A prospective observational cohort study from the Study of Nevi in Children was conducted from January 1, 2009, to December 31, 2014, with a 2- to 3-year follow-up. A total of 569 students from the school system in Framingham, Massachusetts, were enrolled in the 8th or 9th grade (baseline; mean [SD] age, 14.4 [0.7] years). The overall retention rate was 73.3%, and 417 students were reassessed in the 11th grade. MAIN OUTCOME AND MEASURES: Mole-prone phenotype in the 11th grade, defined as total nevus count of the back and 1 randomly selected leg in the top decile of the cohort or having any nevi greater than 5 mm in diameter. RESULTS: Of the 417 students assessed at follow-up in the 11th grade (166 females and 251 males; mean [SD] age, 17.0 [0.4] years), 111 participants (26.6%) demonstrated a mole-prone phenotype: 69 students (62.2%) with 1 nevus greater than 5 mm in diameter, 23 students (20.7%) with total nevus count in the top decile, and 19 students (17.1%) with both characteristics. On multivariate analysis, baseline total nevus count (adjusted odds ratio, 9.08; 95% CI, 4.0-23.7; P < .001) and increased variability of nevus dermoscopic pattern (adjusted odds ratio, 4.24; 95% CI, 1.36-13.25; P = .01) were associated with a mole-prone phenotype. CONCLUSIONS AND RELEVANCE: This study found clinically recognizable factors associated with a mole-prone phenotype that may facilitate the identification of individuals at risk for melanoma. These findings could have implications for primary prevention strategies and help target at-risk adolescents for higher-intensity counseling about sun protection and skin self-examination.

Original languageEnglish
Pages (from-to)990-998
Number of pages9
JournalJAMA Dermatology
Issue number10
StatePublished - Oct 2017


FundersFunder number
National Institutes of Health
National Cancer Institute
National Institute of General Medical Sciences
National Institute of Arthritis and Musculoskeletal and Skin DiseasesP41-GM103545, R01AR049342


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