Department of Public Health Sciences, Queen's University, Carruthers Hall, 62 Fifth Field Company Lane 2nd floor, Kingston, ON, K7L 3N6, Canada.
Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, CancerControl Alberta, Calgary, AB, Canada.
Cancer Causes Control. 2021 Mar;32(3):279-290. doi: 10.1007/s10552-020-01382-1. Epub 2021 Jan 4.
Ultraviolet radiation (UVR) is an established cause of non-melanoma skin cancer (NMSC)-basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The aim of this study was to estimate the current burden of BCC and SCC associated with UVR and modifiable UVR behaviours (sunburn, sunbathing, and indoor tanning) in Canada in 2015.
The current burden of BCC and SCC associated with UVR was estimated by comparing 2015 incidence rates with rates of less exposed body sites (trunk and lower limbs) after adjusting for estimated surface areas. The burden associated with modifiable UVR behaviours was estimated by using prevalence estimates among Caucasians from the Second National Sun Survey, and relative risks that are generalizable to Canadians from conducting meta-analyses of relevant studies.
We estimated that 80.5% of BCCs and 83.0% of SCCs were attributable to UVR. Adult sunburn was associated with relative risks of 1.85 (95% CI 1.15-3.00) for BCC and 1.41 (95% CI 0.91-2.18) for SCC, while adult sunbathing was associated with relative risks of 1.82 (95% CI 1.52-2.17) for BCC and 1.14 (95% CI 0.53-2.46) for SCC. We estimated that 18.6% of BCCs and 9.9% of SCCs were attributable to adult sunburn, while 28.1% of BCCs were attributable to adult sunbathing. We estimated that 46.2% of BCCs and 17.3% of SCCs were attributable to modifiable UVR behaviours combined.
Our results provide quantifiable estimates of the potentially avoidable burden of NMSCs among Canadians. These estimates can be used to motivate prevention efforts in Canada.
紫外线（UVR）是导致非黑色素瘤皮肤癌（NMSC）-基底细胞癌（BCC）和鳞状细胞癌（SCC）的一个既定因素。本研究的目的是估计 2015 年加拿大与 UVR 和可改变的 UVR 行为（晒伤、日光浴和室内晒黑）相关的 BCC 和 SCC 的当前负担。
通过将 2015 年的发病率与暴露面积较少的身体部位（躯干和下肢）的发病率进行比较，来估计与 UVR 相关的 BCC 和 SCC 的当前负担。通过使用第二次全国太阳调查中白种人患病率的估计值，并通过对相关研究进行荟萃分析，将可改变的 UVR 行为的相对风险推广到加拿大人，来估计与可改变的 UVR 行为相关的负担。
我们估计 80.5%的 BCC 和 83.0%的 SCC 归因于 UVR。成人晒伤与 BCC 的相对风险为 1.85（95%CI 1.15-3.00），与 SCC 的相对风险为 1.41（95%CI 0.91-2.18），而成人日光浴与 BCC 的相对风险为 1.82（95%CI 1.52-2.17），与 SCC 的相对风险为 1.14（95%CI 0.53-2.46）。我们估计 18.6%的 BCC 和 9.9%的 SCC 归因于成人晒伤，而 28.1%的 BCC 归因于成人日光浴。我们估计，可改变的 UVR 行为共同导致了 46.2%的 BCC 和 17.3%的 SCC。
我们的研究结果提供了可量化的估计，说明加拿大的 NMSC 中潜在可避免的负担。这些估计可以用来激励加拿大的预防工作。
