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美国成年人 20 岁或以上人群中砷暴露与黑色素瘤,2003-2016 年。

Arsenic Exposure and Melanoma Among US Adults Aged 20 or Older, 2003-2016.

机构信息

12284 Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.

Department of Dermatology, University of Nebraska Medical Center, Omaha, NE, USA.

出版信息

Public Health Rep. 2022 May-Jun;137(3):548-556. doi: 10.1177/00333549211008886. Epub 2021 May 10.

Abstract

OBJECTIVES

Chronic exposure to arsenic has been reported as a risk factor for nonmelanoma skin cancer, notably squamous cell carcinoma. However, current knowledge is limited about the association between arsenic exposure and melanoma. Our objectives were to (1) measure the association between total urinary arsenic levels and melanoma compared with nonmelanoma skin cancer and no cancer and (2) analyze the association between water source and melanoma and nonmelanoma skin cancer.

METHODS

We collected cross-sectional data from the 2003-2016 cycles of the National Health and Nutrition Examination Survey. We conducted univariate and multivariate logistic regressions. To evaluate the possible association of skin cancer with source of tap water, we calculated odds ratios for participants with melanoma and nonmelanoma skin cancer, compared with participants with no cancer.

RESULTS

White race, higher education, higher socioeconomic status, and smoking history were associated with melanoma and nonmelanoma skin cancer in the full study population. After adjusting for age and race/ethnicity, the adjusted odds ratio of participants with >50 μg/L of total urinary arsenic for melanoma or nonmelanoma skin cancer was 1.87 (95% CI, 0.58-6.05) and 2.23 (95% CI, 1.12-4.45) times higher compared with no cancer, respectively. Participants with nonmelanoma skin cancer had 2.06 increased odds of reporting a nonmunicipal water source compared with participants without cancer.

CONCLUSIONS

We did not find a relationship between the incidence of melanoma and exposure to arsenic among US adults. Nonmunicipal water sources were associated with nonmelanoma skin cancer and should be further investigated.

摘要

目的

有报道称,慢性砷暴露是皮肤癌(尤其是鳞状细胞癌)的一个风险因素。然而,目前对于砷暴露与黑色素瘤之间的关系知之甚少。我们的目的是:(1)测定总尿砷水平与黑色素瘤的相关性,与非黑色素瘤皮肤癌和无癌症进行比较;(2)分析水来源与黑色素瘤和非黑色素瘤皮肤癌之间的关系。

方法

我们收集了 2003-2016 年国家健康和营养调查周期的横断面数据。我们进行了单变量和多变量逻辑回归分析。为了评估皮肤癌与自来水来源的可能关联,我们计算了黑色素瘤和非黑色素瘤皮肤癌患者与无癌症患者相比的比值比。

结果

在全人群中,白种人、高学历、高社会经济地位和吸烟史与黑色素瘤和非黑色素瘤皮肤癌相关。在调整年龄和种族/族裔后,总尿砷>50μg/L 的参与者中,黑色素瘤或非黑色素瘤皮肤癌的调整比值比分别为 1.87(95%CI,0.58-6.05)和 2.23(95%CI,1.12-4.45)倍,高于无癌症者。与无癌症者相比,患有非黑色素瘤皮肤癌的参与者报告非市政水源的可能性增加了 2.06 倍。

结论

我们未发现美国成年人黑色素瘤发病率与砷暴露之间存在关系。非市政水源与非黑色素瘤皮肤癌相关,应进一步调查。

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