Kricker A, Armstrong B K, English D R, Heenan P J
NH & MRC Research Unit in Epidemiology and Preventive Medicine, University of Western Australia, Nedlands.
Int J Cancer. 1991 Jul 9;48(5):650-62. doi: 10.1002/ijc.2910480504.
The roles of ethnic origin, pigmentary traits, sun sensitivity and other cutaneous characteristics as risk factors for basal-cell carcinoma (BCC) and squamous-cell carcinoma (SCC) were examined in a case-control study of prevalent and incident cases of histopathologically confirmed skin cancers. Two hundred and twenty six confirmed cases of BCC, 45 of SCC and 1,015 controls with no lesions were identified in a population-based survey of skin cancer in 1987 in Geraldton, Western Australia. The risk of both cancers was higher in native-born Australians than in migrants. The risk of BCC decreased with increasing age at arrival in Australia. Southern European ancestry was strongly protective against BCC (for any southern European grandparents) and SCC (no case of SCC had any grandparents of southern European origin). Inability to tan was the strongest pigmentary risk factor for both BCC and SCC. Among factors that incorporated a measure of sun exposure as well as sun sensitivity, freckling on the arm in childhood was important for both cancers, the number of moles on the back was important for BCC, and forearm skin colour and having a permanent colour difference between the neck and adjacent protected areas were important for SCC. Among measures of sun damage to the skin, solar elastosis of the neck was a strong risk factor for both BCC and SCC, loss of fine texture of the skin of the back of the hands (as measured by cutaneous microtopography) was important for BCC and telangiectasia of the face for SCC. When all important variables for each cancer were examined together in a single model with age, sex, migrant status or age at arrival in Australia, and ethnicity, in ability to tan, solar elastosis of the neck, and the number of moles on the back were independently significant risk factors for BCC and solar elastosis of the neck and having a permanent colour difference between the neck and adjacent protected areas were independently significant risk factors for SCC. The effects of age at arrival or migrant status and ethnic origin remained important in the models incorporating these factors. A history of ever having acne and a history of warts were protective for BCC and a history of acne was protective for SCC.
在一项针对组织病理学确诊皮肤癌的现患病例和新发病例的病例对照研究中，对种族起源、色素沉着特征、日光敏感性及其他皮肤特征作为基底细胞癌（BCC）和鳞状细胞癌（SCC）风险因素的作用进行了研究。在1987年于西澳大利亚州杰拉尔顿开展的一项基于人群的皮肤癌调查中，共识别出226例确诊的BCC病例、45例SCC病例以及1015名无病变的对照者。在澳大利亚本土出生的人患这两种癌症的风险高于移民。抵达澳大利亚时的年龄越大，患BCC的风险越低。南欧血统对BCC（任何一位祖父母为南欧血统）和SCC（无SCC病例的祖父母为南欧血统）具有很强的保护作用。无法晒黑是BCC和SCC最强的色素沉着风险因素。在纳入日光暴露及日光敏感性测量的因素中，儿童时期手臂上有雀斑对这两种癌症都很重要，背部痣的数量对BCC很重要，前臂肤色以及颈部与相邻受保护区域之间存在永久性肤色差异对SCC很重要。在皮肤日光损伤的测量指标中，颈部的日光性弹力组织变性是BCC和SCC的强风险因素，手背皮肤细纹丧失（通过皮肤微观地形图测量）对BCC很重要，面部毛细血管扩张对SCC很重要。当在一个包含年龄、性别、移民身份或抵达澳大利亚时的年龄以及种族的单一模型中共同检查每种癌症的所有重要变量时，无法晒黑、颈部的日光性弹力组织变性以及背部痣的数量是BCC的独立显著风险因素，颈部的日光性弹力组织变性以及颈部与相邻受保护区域之间存在永久性肤色差异是SCC的独立显著风险因素。在纳入这些因素的模型中，抵达时的年龄或移民身份以及种族起源的影响仍然很重要。曾患痤疮的病史和疣病史对BCC有保护作用，痤疮病史对SCC有保护作用。
