Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland.
School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
Cancer Epidemiol Biomarkers Prev. 2021 Oct;30(10):1932-1946. doi: 10.1158/1055-9965.EPI-20-1815. Epub 2021 Jul 21.
Cutaneous basal cell carcinoma (BCC) has long been associated with UV radiation (UVR) exposure, but data are limited on risks by anatomic site.
We followed 63,912 cancer-free White U.S. radiologic technologists from cohort entry (1983-1989/1994-1998) to exit (date first BCC via 2003-2005 questionnaire). We estimated associations between cumulative ambient UVR and relative/absolute risks of self-reported BCC by anatomic location via Poisson models.
For incident first primary BCC in 2,124 subjects (mean follow-up, 16.9 years) log[excess relative risks] (ERR) of BCC per unit cumulative ambient UVR = 1.27/MJ cm [95% confidence interval (CI): 0.86-1.68; < 0.001] did not vary by anatomic site ( = 0.153). However, excess absolute risks of BCC per unit cumulative ambient UVR were large for the head/neck = 5.46/MJ cm/10 person-year (95% CI: 2.92-7.36; < 0.001), smaller for the trunk (2.56; 95% CI: 1.26-3.33; = 0.003), with lesser increases elsewhere. There were lower relative risks, but higher absolute risks, for those with Gaelic ancestry ( < 0.001), also higher absolute risks among those with fair complexion, but relative and absolute risks were not generally modified by other constitutional, lifestyle or medical factors for any anatomic sites. Excess absolute and relative risk was concentrated 5-15 years before time of follow-up.
BCC relative and absolute risk rose with increasing cumulative ambient UVR exposure, with absolute risk highest for the head/neck, to a lesser extent in the trunk.
These associations should be evaluated in other White and other racial/ethnic populations along with assessment of possible modification by time outdoors, protective, and behavioral factors.
皮肤基底细胞癌（BCC）长期以来一直与紫外线辐射（UVR）暴露有关，但有关解剖部位风险的数据有限。
我们随访了 63912 名无癌症的美国白人放射技师，从队列进入（1983-1989 年/1994-1998 年）到退出（2003-2005 年问卷调查时首次报告 BCC 的日期）。我们通过泊松模型估计了累积环境 UVR 与按解剖部位报告的 BCC 的相对/绝对风险之间的关联。
在 2124 名受试者（平均随访 16.9 年）中，首次原发性 BCC 的发生率（log[超额相对风险]（ERR））与单位累积环境 UVR 之间的关系为 1.27/MJ cm [95%置信区间（CI）：0.86-1.68；<0.001]，与解剖部位无关（=0.153）。然而，单位累积环境 UVR 引起的 BCC 超额绝对风险较大，头颈部为 5.46/MJ cm/10 人年（95%CI：2.92-7.36；<0.001），躯干较小（2.56；95%CI：1.26-3.33；=0.003），其他部位则有所减少。具有盖尔人血统的个体的相对风险较低，但绝对风险较高（<0.001），皮肤白皙的个体的绝对风险也较高，但相对和绝对风险通常不受任何解剖部位的其他体质、生活方式或医疗因素的影响。超额的绝对和相对风险集中在随访前 5-15 年。
BCC 的相对和绝对风险随着累积环境 UVR 暴露的增加而增加，头颈部的绝对风险最高，躯干的风险略低。
应在其他白人和其他种族/族裔人群中评估这些关联，同时评估户外时间、保护和行为因素可能产生的影响。
