Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital.
Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
J Glaucoma. 2020 Jun;29(6):448-455. doi: 10.1097/IJG.0000000000001496.
In a cohort study of 120,307 participants with 25+ years of follow-up, a history of nonmelanoma skin cancer (NMSC) was associated with a 40% higher exfoliation glaucoma (XFG) risk.
The purpose of this study was to evaluate the relationship between NMSC (a marker of ultraviolet radiation exposure) and XFG.
We performed a cohort study of US women (n=79,102; 1980-2014) and men (n=41,205; 1986-2014), aged 40+ years and at risk for glaucoma who reported eye examinations. From 1984 (women)/1988 (men), we asked about basal cell carcinoma or squamous cell carcinoma history separately; in prior years, we asked about any NMSC history in a single question. Squamous cell carcinoma was confirmed with histopathology reports while basal cell carcinoma and any early (<1984/<1988) NMSC history was self-reported. Incident XFG cases (362 women and 83 men) were confirmed with medical records. Using pooled data, we estimated multivariable-adjusted relative risks [MVRRs; 95% confidence intervals (CIs)] with Cox proportional hazards models that were stratified by age (in mo), 2-year time period at risk and average lifetime residential latitude.
In multivariable-adjusted analyses, we observed a 40% higher XFG risk with any NMSC history (MVRR=1.40; 95% CI=1.08-1.82); the association was observed even with 4 and 8-year lags in NMSC history. Also, the NMSC association was stronger in younger (below 65 y; MVRR=2.56; 95% CI=1.62-4.05) versus older participants (65 y and above; MVRR=1.25; 95% CI=0.94-1.66; P for interaction=0.01) and those living in the northern latitudes (≥42°N; MVRR=1.92; 95% CI=1.28-2.88) versus more southern latitudes (<42°N; MVRR=1.19; 95% CI=0.86-1.66; P for interaction=0.04).
NMSC was associated with higher XFG risk, particularly among younger participants and those living in the Northern US.
本研究旨在评估非黑色素瘤皮肤癌（NMSC，紫外线暴露的标志物）与 XFG 之间的关系。
我们进行了一项队列研究，纳入了美国女性（n=79102；1980-2014 年）和男性（n=41205；1986-2014 年），年龄在 40 岁及以上，有患青光眼风险，并报告了眼部检查情况。从 1984 年（女性）/1988 年（男性）开始，我们分别询问基底细胞癌或鳞状细胞癌的病史；在之前的年份，我们在一个问题中询问了任何 NMSC 的病史。鳞状细胞癌通过组织病理学报告证实，而基底细胞癌和任何早期（<1984/<1988 年）NMSC 病史则通过自我报告。通过医疗记录确认新发 XFG 病例（362 名女性和 83 名男性）。使用汇总数据，我们通过 Cox 比例风险模型估计了多变量调整后的相对风险[MVRR；95%置信区间（CI）]，该模型按年龄（月）、2 年风险期和平均终生居住纬度进行分层。
在多变量调整分析中，我们观察到任何 NMSC 病史的 XFG 风险增加了 40%（MVRR=1.40；95%CI=1.08-1.82）；即使在 NMSC 病史有 4 年和 8 年的滞后，这种关联仍然存在。此外，NMSC 相关性在较年轻（<65 岁；MVRR=2.56；95%CI=1.62-4.05）和较年长（≥65 岁；MVRR=1.25；95%CI=0.94-1.66；P 交互=0.01）参与者以及生活在较北纬度（≥42°N；MVRR=1.92；95%CI=1.28-2.88）和较南纬度（<42°N；MVRR=1.19；95%CI=0.86-1.66；P 交互=0.04）的参与者中更强。
NMSC 与更高的 XFG 风险相关，尤其是在较年轻的参与者和生活在美国北部的参与者中。
