Melanoma risk in airline pilots and cabin crew: A narrative review of occupational and non-occupational factors

Cutaneous malignant melanoma is one of the most aggressive skin cancers, with a steadily increasing incidence worldwide. Epidemiological studies suggest that airline pilots and cabin crew have approximately twice the melanoma risk of the general population. The aim of this review was to summarize current evidence regarding melanoma risk factors in flight personnel. A literature review was conducted using PubMed and related scientific databases, focusing on cohort studies and meta-analyses, and a report evaluating melanoma incidence and associated risk factors among airline crews. Current evidence indicates that melanoma risk in flight personnel is multifactorial. Major occupational factors include increased exposure to ultraviolet A (UVA) radiation at cruising altitude, cosmic ionizing radiation, and circadian rhythm disruption related to shift work and transmeridian travel. Lifestyle-related intermittent sun exposure during stopovers and holidays may further increase risk. Individual susceptibility is associated with fair skin phototypes, light hair color, and a high number of melanocytic naevi. Understanding these interacting occupational and individual factors may improve prevention strategies, including enhanced UV protection, occupational monitoring, and regular dermatological screening.