REVIEW ARTICLE BJD British Journal of Dermatology Alcohol drinking and cutaneous melanoma risk: a systematic review and dose–risk meta-analysis* M. Rota, 1,2 E. Pasquali, 3 R. Bellocco, 3,4 V. Bagnardi, 3,5 L. Scotti, 3 F. Islami, 6,7 E. Negri, 2 P. Boffetta, 6 C. Pelucchi, 2 G. Corrao 3 and C. La Vecchia 2,8 1 Department of Health Sciences, Centre of Biostatistics for Clinical Epidemiology, and 3 Department of Statistics and Quantitative Methods, University of Milan- Bicocca, Milan, Italy 2 Department of Epidemiology, IRCCS – Istituto di Ricerche Farmacologiche Mario Negri, Via G. La Masa 19, 20156 Milan, Italy 4 Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden 5 Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy 6 The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, U.S.A. 7 Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran 8 Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy Correspondence Eva Negri. E-mail: eva.negri@marionegri.it Accepted for publication 19 January 2014 Funding sources This work was supported by the Italian Association of Cancer Research, project nos 10068 and 10258. M.R. was supported by a fellowship of the Fondazione Umberto Veronesi. R.B. was par- tially supported by the Italian Ministry of Univer- sity and Research, project number PRIN-2009, X8YCBN. Conflicts of interest None declared. *Plain language summary available online DOI 10.1111/bjd.12856 Summary It has been suggested that alcohol intake increases sunburn severity, a major risk factor for cutaneous melanoma (CM). Several epidemiological studies have investigated the relationship between alcohol consumption and CM, but the evidence is inconsistent. Therefore, we aimed to quantify this relationship bet- ter, using a meta-analytical approach. The dose–risk relationship was also mod- elled through a class of flexible nonlinear meta-regression random effects models. The present meta-analysis included 16 studies (14 case–control and two cohort investigations) with a total of 6251 cases of CM. The pooled rela- tive risk (RR) for any alcohol drinking compared with no/occasional drinking was 1Á20 [95% confidence interval (CI) 1Á06–1Á37]. The risk estimate was similar in case–control (RR 1Á20, 95% CI 1Á01–1Á44) and cohort studies (RR 1Á26, 95% CI 1Á19–1Á35). The pooled RR was 1Á10 (95% CI 0Á96–1Á26) for light alcohol drinking (≤ 1 drink per day) and 1Á18 (95% CI 1Á01–1Á40) for moderate-to-heavy drinking. The pooled RR from 10 studies adjusting for sun exposure was 1Á15 (95% CI 0Á94–1Á41), while the RR from six unadjusted studies was 1Á27 (95% CI 1Á20–1Á35). No evidence of publication bias was detected. This meta-analysis of published data reveals that alcohol consumption is positively associated with the risk of CM. However, caution in interpreting these results is required, as residual confounding by sun exposure cannot be ruled out. What’s already known about this topic? • Alcohol drinking increases sunburn severity, a major risk factor for cutaneous melanoma. • Several epidemiological studies have investigated the relationship between alcohol consumption and cutaneous melanoma, but the evidence is inconsistent. What does this study add? • We found a 20% increased risk of cutaneous melanoma with regular alcohol drinking. © 2014 British Association of Dermatologists British Journal of Dermatology (2014) 170, pp1021–1028 1021