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高防晒系数与低防晒系数防晒霜与皮肤鳞状细胞癌风险:一项基于人群的队列研究。

Sunscreens With High Versus Low Sun Protection Factor and Cutaneous Squamous Cell Carcinoma Risk: A Population-Based Cohort Study.

出版信息

Am J Epidemiol. 2022 Jan 1;191(1):75-84. doi: 10.1093/aje/kwab216.

Abstract

Evidence on sunscreen use and cutaneous squamous cell carcinoma (cSCC) risk is limited. Most studies have not taken sun protection factor (SPF) into consideration and used nonusers of sunscreen as the reference group. Nonusers are likely a priori at lower cSCC risk than users. No study has investigated the effect of high- versus low-SPF sunscreens on cSCC, appropriately adjusting for time-varying confounding. Using data from the Norwegian Women and Cancer Study (1991-2016), we investigated whether use of SPF ≥15 versus SPF <15 sunscreens reduces cSCC risk. We used a marginal structural Cox proportional hazards model with inverse probability of treatment and censoring weights to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During follow-up of 148,781 women (mean follow-up, 14.3 years), 653 women were diagnosed with cSCC. The effect on cSCC risk of sunscreens with SPF ≥15 versus SPF <15 was close to the null when used at any latitudes (HR = 1.02, 95% CI: 0.82, 1.27) and when used in lower-latitude settings (HR = 1.05, 95% CI: 0.84, 1.32). In conclusion, we found no indication that sunscreens with SPF ≥15 reduced Norwegian women's cSCC risk more than sunscreens with SPF <15, suggesting that either there is no difference in their effects long-term or the difference is diluted by incorrect application.

摘要

防晒霜使用与皮肤鳞状细胞癌(cSCC)风险的证据有限。大多数研究都没有考虑防晒系数(SPF),并且将防晒霜的非使用者作为参考组。非使用者在理论上比使用者的 cSCC 风险更低。没有研究调查过高 SPF 和低 SPF 防晒霜对 cSCC 的影响,也没有适当调整时间变化的混杂因素。利用挪威妇女与癌症研究(1991-2016 年)的数据,我们调查了使用 SPF≥15 与 SPF<15 防晒霜是否能降低 cSCC 风险。我们使用逆概率处理和删失加权的边缘结构 Cox 比例风险模型来估计危险比(HR)和 95%置信区间(CI)。在对 148781 名女性(平均随访时间为 14.3 年)的随访期间,有 653 名女性被诊断患有 cSCC。在任何纬度(HR=1.02,95%CI:0.82,1.27)和在低纬度地区(HR=1.05,95%CI:0.84,1.32)使用 SPF≥15 与 SPF<15 的防晒霜对 cSCC 风险的影响接近零。总之,我们没有发现 SPF≥15 的防晒霜比 SPF<15 的防晒霜更能降低挪威女性的 cSCC 风险,这表明它们的效果要么长期没有差异,要么差异被错误的应用稀释了。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af0f/8751784/00de6b18393f/kwab216f1.jpg

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