In 2005, a meta-analysis found that varying types of UV exposure contributed to an increased relative risk of melanoma. Recently, a 2021 review failed to establish a similar link in individuals with skin of color. Within the last 2 decades, no studies have comprehensively reviewed the risk of varying types of UV exposure on melanoma in fair skin. Thus, we performed a systematic review from 2002-2021 analyzing UV exposure and melanoma risk in Fitzpatrick type I-IV individuals. Out of 12,263 studies, 26 met inclusion criteria. A majority showed an association with UV index (6/9), left-sided laterality (1/1), sunburn history (11/13), and outdoor leisure activity (3/3). UV index studies were all ecological and presented primarily positive correlations. For sunburn history, studies encompassed 2309 melanomas, and significant odds ratios (OR) ranged from 1.69 (1.00-2.98) to 8.48 (4.35-16.54) with higher odds ratios for increasing numbers of sunburns. For outdoor leisure correlating with prior definitions of intermittent sun exposure, studies encompassed 514 melanomas, and ORs ranged from 2.70 (1.04-6.80) to 4.18 (1.83-9.93). A positive association was found in 2 (n = 2/6) studies for cumulative or annual sun exposure, 2 (n = 2/5) studies with occupational sun exposure, 2 (n = 2/4) studies with sun vacations, and 0 (n = 0/2) studies with latitude. This study highlights the significant relationships between specific types of UV exposure and melanoma at higher rates than previously summarized due to an emphasis on fair skin types. Critically, there remains high heterogeneity in how UV exposure is captured that may contribute to mixed results
