Agent Orange Exposure and Acral Melanoma: Uncovering Non-Ultraviolet Risk Factors in the US Veteran Population

Agent Orange exposure (AOE) is significantly associated with an increased risk of acral melanoma (AM), with adjusted odds ratios ranging from 1.27 to 1.31.
Current smoking exhibits a paradoxical inverse association with AM risk, similar to patterns seen in some other non-UV-related cancers.
Acral melanoma risk factors differ substantially from nonacral cutaneous melanoma (CM), particularly regarding the prevalence of UV-related precursors like actinic keratosis and keratinocyte carcinoma.
The study utilizes a robust natural language processing (NLP) pipeline to identify AM cases within the massive Veterans Affairs (VA) health care system, providing a high level of statistical power.

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