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Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer. I. Basal cell carcinoma.

Abstract

BACKGROUND AND DESIGN

Basal cell carcinoma (BCC) of the skin is the most common neoplasm in white populations, and solar radiation is generally accepted to be the dominant environmental risk factor for this disease. However, little information is available on the nature of the relationship between BCC and sunlight. The purpose of this study was to evaluate the nature of the relationship between sunlight exposure, pigmentary factors, and BCC of the skin. A population-based case-control study of 226 male patients with BCC diagnosed from January 1, 1983, through December 31, 1984, and 406 randomly selected male control subjects was conducted in Alberta, Canada. The study was conducted using a standardized questionnaire, administered in person by trained interviewers. Data were analyzed using conditional logistic regression methods.

RESULTS

After controlling for other host and pigmentary factors, the risk of BCC was increased in subjects with light skin color and those who freckled in childhood. A history of severe sunburn in childhood also increased risk. Subjects of southern European ethnic origin were at significantly lower risk of BCC. Surprisingly, no association was seen between mean annual cumulative summer sunlight exposure and risk of BCC. A significantly increased risk of BCC was seen in subjects with increased recreational sunlight exposure in adolescence and childhood (age, 0 to 19 years), although an inverse relationship was seen with lifetime recreation exposure. The relationship with childhood sun exposure was most pronounced among sun-sensitive subjects whose skin tended to burn rather than tan in the sun.

CONCLUSIONS

The lack of association between cumulative sun exposure and BCC contradicts conventional wisdom about the cause of this tumor, and the increased risk with sun exposure at age 0 to 19 years suggests that childhood and adolescence may be critical periods for establishing adult risk for BCC.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    British Columbia Cancer Agency, Vancouver.

    , , , , ,

    Source

    Archives of dermatology 131:2 1995 Feb pg 157-63

    MeSH

    Adult
    Aged
    Carcinoma, Basal Cell
    Case-Control Studies
    Environmental Exposure
    Humans
    Male
    Middle Aged
    Odds Ratio
    Risk Factors
    Skin Neoplasms
    Skin Pigmentation
    Sunlight

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    7857111

    Citation

    Gallagher, R P., et al. "Sunlight Exposure, Pigmentary Factors, and Risk of Nonmelanocytic Skin Cancer. I. Basal Cell Carcinoma." Archives of Dermatology, vol. 131, no. 2, 1995, pp. 157-63.
    Gallagher RP, Hill GB, Bajdik CD, et al. Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer. I. Basal cell carcinoma. Arch Dermatol. 1995;131(2):157-63.
    Gallagher, R. P., Hill, G. B., Bajdik, C. D., Fincham, S., Coldman, A. J., McLean, D. I., & Threlfall, W. J. (1995). Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer. I. Basal cell carcinoma. Archives of Dermatology, 131(2), pp. 157-63.
    Gallagher RP, et al. Sunlight Exposure, Pigmentary Factors, and Risk of Nonmelanocytic Skin Cancer. I. Basal Cell Carcinoma. Arch Dermatol. 1995;131(2):157-63. PubMed PMID: 7857111.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer. I. Basal cell carcinoma. AU - Gallagher,R P, AU - Hill,G B, AU - Bajdik,C D, AU - Fincham,S, AU - Coldman,A J, AU - McLean,D I, AU - Threlfall,W J, PY - 1995/2/1/pubmed PY - 1995/2/1/medline PY - 1995/2/1/entrez SP - 157 EP - 63 JF - Archives of dermatology JO - Arch Dermatol VL - 131 IS - 2 N2 - BACKGROUND AND DESIGN: Basal cell carcinoma (BCC) of the skin is the most common neoplasm in white populations, and solar radiation is generally accepted to be the dominant environmental risk factor for this disease. However, little information is available on the nature of the relationship between BCC and sunlight. The purpose of this study was to evaluate the nature of the relationship between sunlight exposure, pigmentary factors, and BCC of the skin. A population-based case-control study of 226 male patients with BCC diagnosed from January 1, 1983, through December 31, 1984, and 406 randomly selected male control subjects was conducted in Alberta, Canada. The study was conducted using a standardized questionnaire, administered in person by trained interviewers. Data were analyzed using conditional logistic regression methods. RESULTS: After controlling for other host and pigmentary factors, the risk of BCC was increased in subjects with light skin color and those who freckled in childhood. A history of severe sunburn in childhood also increased risk. Subjects of southern European ethnic origin were at significantly lower risk of BCC. Surprisingly, no association was seen between mean annual cumulative summer sunlight exposure and risk of BCC. A significantly increased risk of BCC was seen in subjects with increased recreational sunlight exposure in adolescence and childhood (age, 0 to 19 years), although an inverse relationship was seen with lifetime recreation exposure. The relationship with childhood sun exposure was most pronounced among sun-sensitive subjects whose skin tended to burn rather than tan in the sun. CONCLUSIONS: The lack of association between cumulative sun exposure and BCC contradicts conventional wisdom about the cause of this tumor, and the increased risk with sun exposure at age 0 to 19 years suggests that childhood and adolescence may be critical periods for establishing adult risk for BCC. SN - 0003-987X UR - https://www.unboundmedicine.com/medline/citation/7857111/Sunlight_exposure_pigmentary_factors_and_risk_of_nonmelanocytic_skin_cancer__I__Basal_cell_carcinoma_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/vol/131/pg/157 DB - PRIME DP - Unbound Medicine ER -