Department of Epidemiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
PLoS Med. 2013;10(4):e1001433. doi: 10.1371/journal.pmed.1001433. Epub 2013 Apr 23.
Previous studies suggest a positive association between history of non-melanoma skin cancer (NMSC) and risk of subsequent cancer at other sites. The purpose of this study is to prospectively examine the risk of primary cancer according to personal history of NMSC.
In two large US cohorts, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS), we prospectively investigated this association in self-identified white men and women. In the HPFS, we followed 46,237 men from June 1986 to June 2008 (833,496 person-years). In the NHS, we followed 107,339 women from June 1984 to June 2008 (2,116,178 person-years). We documented 29,447 incident cancer cases other than NMSC. Cox proportional hazard models were used to calculate relative risks (RRs) and 95% confidence intervals (CIs). A personal history of NMSC was significantly associated with a higher risk of other primary cancers excluding melanoma in men (RR=1.11; 95% CI 1.05-1.18), and in women (RR=1.20; 95% CI 1.15-1.25). Age-standardized absolute risk (AR) was 176 in men and 182 in women per 100,000 person-years. For individual cancer sites, after the Bonferroni correction for multiple comparisons (n=28), in men, a personal history of NMSC was significantly associated with an increased risk of melanoma (RR=1.99, AR=116 per 100,000 person-years). In women, a personal history of NMSC was significantly associated with an increased risk of breast (RR=1.19, AR=87 per 100,000 person-years), lung (RR=1.32, AR=22 per 100,000 person-years), and melanoma (RR=2.58, AR=79 per 100,000 person-years).
This prospective study found a modestly increased risk of subsequent malignancies among individuals with a history of NMSC, specifically breast and lung cancer in women and melanoma in both men and women.
先前的研究表明，非黑色素瘤皮肤癌（NMSC）病史与其他部位随后发生癌症的风险呈正相关。本研究的目的是前瞻性地检查个人 NMSC 病史与原发性癌症风险之间的关系。
在两个大型美国队列中，即卫生专业人员随访研究（HPFS）和护士健康研究（NHS），我们前瞻性地调查了自我认定的白种男性和女性中这种关联。在 HPFS 中，我们从 1986 年 6 月至 2008 年 6 月对 46,237 名男性进行了随访（833,496 人年）。在 NHS 中，我们从 1984 年 6 月至 2008 年 6 月对 107,339 名女性进行了随访（2,116,178 人年）。我们记录了 29,447 例非 NMSC 以外的其他癌症病例。Cox 比例风险模型用于计算相对风险（RR）和 95%置信区间（CI）。个人 NMSC 病史与男性（RR=1.11；95%CI 1.05-1.18）和女性（RR=1.20；95%CI 1.15-1.25）中其他原发性癌症（不包括黑色素瘤）的风险显著增加相关。年龄标准化绝对风险（AR）在男性中为每 100,000 人年 176 例，在女性中为每 100,000 人年 182 例。对于个别癌症部位，在进行多次比较的 Bonferroni 校正（n=28）后，男性中，NMSC 病史与黑色素瘤风险增加相关（RR=1.99，AR=每 100,000 人年 116 例）。在女性中，NMSC 病史与乳腺癌（RR=1.19，AR=每 100,000 人年 87 例）、肺癌（RR=1.32，AR=每 100,000 人年 22 例）和黑色素瘤（RR=2.58，AR=每 100,000 人年 79 例）风险增加相关。
这项前瞻性研究发现，有 NMSC 病史的个体随后发生恶性肿瘤的风险略有增加，特别是女性的乳腺癌和肺癌以及男性和女性的黑色素瘤。
