Cumulative ultraviolet radiation flux in adulthood and risk of incident skin cancers in women

Mar 6, 2014British journal of cancer

Lifetime UV exposure in adulthood and the risk of new skin cancers in women

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Abstract

Cumulative UV flux was associated with a significantly lower risk of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in women, with a P for trend <0.0001.

Women in lower quintiles of cumulative UV flux had reduced risk of SCC and BCC compared to those in the highest quintile.
The association between cumulative UV flux and risk of melanoma did not reach statistical significance.
Lag analyses indicated a lower risk of melanoma in women with lower cumulative UV flux, but results were not conclusive.
Multivariable-adjusted hazard ratios indicated a slight decrease in melanoma risk with increasing UV flux, while SCC and BCC risks increased.

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BACKGROUND: Solar ultraviolet (UV) exposure estimated based on residential history has been used as a sun exposure indicator in previous case-control and descriptive studies. However, the associations of cumulative UV exposure based on residential history with different skin cancers, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), have not been evaluated simultaneously in prospective studies.

METHODS: We conducted a cohort study among 108,578 women in the Nurses' Health Study (1976-2006) to evaluate the relative risks of skin cancers with cumulative UV flux based on residential history in adulthood.

RESULTS: Risk of SCC and BCC was significantly lower for women in lower quintiles vs the highest quintile of cumulative UV flux (both P for trend <0.0001). The association between cumulative UV flux and risk of melanoma did not reach statistical significance. However, risk of melanoma appeared to be lower among women in lower quintiles vs the highest quintile of cumulative UV flux in lag analyses with 2-10 years between exposure and outcome. The multivariable-adjusted hazard ratios per 200 × 10(-4) Robertson-Berger units increase in cumulative UV flux were 0.979 (95% confidence interval (CI): 0.933, 1.028) for melanoma, 1.072 (95% CI: 1.041, 1.103) for SCC, and 1.043 (95% CI: 1.034, 1.052) for BCC.

CONCLUSIONS: Associations with cumulative UV exposure in adulthood among women differed for melanoma, SCC, and BCC, suggesting a potential variable role of UV radiation in adulthood in the carcinogenesis of the three major skin cancers.

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Cumulative ultraviolet radiation flux in adulthood and risk of incident skin cancers in women

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