Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia.
Photochem Photobiol. 2017 Nov;93(6):1483-1491. doi: 10.1111/php.12807. Epub 2017 Sep 4.
Sun exposure is the main cause of squamous (SCC) and basal cell carcinoma (BCC) although pattern and amount differ by cancer type, and sun sensitivity is the major host risk factor. Our study investigated risk factors and residential ambient UV in a population-based sample of Australian 45 and Up Study participants: 916 BCC cases, 433 SCC cases, 1224 controls. Unconditional logistic regression models adjusting for key covariates demonstrated 60% increased BCC risk and two-fold increased SCC risk with sun sensitivity, and three- and four-fold increased risk, respectively, with solar keratoses. BCC but not SCC risk increased with higher early-life residential UV in all participants (odds ratio (OR) = 1.54; 95% CI 1.22-1.96 for intermediate; OR = 1.31; 95% CI 1.03-1.68 for high UV at birthplace) and similarly in Australian-born participants (P-values < 0.05). Risk of SCC but not BCC increased with long-term cumulative sun exposure assessed by self-reported outdoor work (OR 1.74, 95% CI 1.21-2.49). In conclusion, sun sensitivity is important for both cancers, early-life UV but not cumulative UV appears to increase BCC risk, the former an apparently novel finding, and SCC risk appears only to be related to long-term cumulative sun exposure.
阳光暴露是鳞状细胞癌(SCC)和基底细胞癌(BCC)的主要原因,尽管每种癌症的类型和程度不同,且阳光敏感度是主要的宿主风险因素。我们的研究调查了澳大利亚 45 岁及以上研究参与者中的基于人群的样本中的风险因素和住宅环境紫外线:916 例 BCC 病例、433 例 SCC 病例、1224 例对照。在调整了关键协变量后,非条件逻辑回归模型表明,阳光敏感会使 BCC 风险增加 60%,SCC 风险增加两倍,而分别有 3 倍和 4 倍的风险增加与日光性角化病有关。BCC 但不是 SCC 风险随着所有参与者早期居住环境中的紫外线增加而增加(比值比(OR)=1.54;95%置信区间 1.22-1.96 为中值;OR = 1.31;95%置信区间 1.03-1.68 为出生时的高紫外线),而在澳大利亚出生的参与者中也是如此(P 值<0.05)。SCC 风险而不是 BCC 风险随着自我报告的户外工作所评估的长期累积阳光暴露而增加(OR 1.74,95%置信区间 1.21-2.49)。总之,阳光敏感对两种癌症都很重要,早期生活中的紫外线而不是累积紫外线似乎会增加 BCC 风险,这是一个明显的新发现,而 SCC 风险似乎仅与长期累积阳光暴露有关。