美国放射技师全国队列研究中住宅环境紫外线B、紫外线A与角质形成细胞癌发病率的关系

Residential ambient ultraviolet B and ultraviolet A and incidence of keratinocyte carcinoma in the nationwide US Radiologic Technologists cohort.

作者信息

Mai Jim Z, Kitahara Cari M, Sargen Michael R, Little Mark P, Alexander Bruce H, Linet Martha S, Cahoon Elizabeth K

机构信息

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA.

Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA.

出版信息

Br J Dermatol. 2025 May 29. doi: 10.1093/bjd/ljaf206.

DOI:10.1093/bjd/ljaf206

PMID:40440356

Abstract

BACKGROUND

Few epidemiological studies have distinguished the effects of solar ultraviolet radiation (UVR) wavelength, including UVB and UVA, on the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin.

OBJECTIVES

We aimed to evaluate the association between ambient UVB and UVA with BCC and SCC incidence.

METHODS

Using data from the nationwide U.S. Radiologic Technologists cohort, satellite-based noontime ambient UVR was obtained based on residential history (<13, 13-19, 20-39, 40-64, and ≥65 years). Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated for associations between UVB, UVA quintile (Q), and first primary BCC and SCC in mutually adjusted and stratified models, additionally adjusted for sun sensitivity characteristics.

RESULTS

There were 62,595 non-Hispanic White participants aged 22-90 years at baseline (1983-1998). During a median 25.5 years of follow-up, 6,339 incident BCCs and 1,253 incident SCCs were reported. Annual and summer UVB and UVA were each positively associated with both BCC and SCC risk before mutual adjustment. After adjusting for UVA, summer (but not annual) UVB Q5 versus Q1 was associated with BCC (IRR=1.41; 95% CI: 1.13, 1.77) and SCC (IRR=1.69; 95% CI: 1.01, 2.84). After adjusting for UVB, annual (but not summer) UVA Q5 versus Q1 was associated with BCC (IRR=1.42; 95% CI: 1.13, 1.77) and SCC (IRR=1.84; 95% CI: 1.10, 3.06).

CONCLUSIONS

Both summer UVB and annual UVA were independently associated with both higher risks of BCC and SCC. Our results suggest that cumulative lifetime UVA may be an underappreciated contributor to BCC and SCC risk. With confirmation, these findings suggest public health interventions promoting avoidance of excessive UVB and UVA among susceptible populations.

摘要

背景

很少有流行病学研究区分太阳紫外线辐射（UVR）的波长，包括中波紫外线（UVB）和长波紫外线（UVA），对皮肤基底细胞癌（BCC）和鳞状细胞癌（SCC）风险的影响。

目的

我们旨在评估环境中UVB和UVA与BCC和SCC发病率之间的关联。

方法

利用美国放射技师全国队列的数据，根据居住史（<13岁、13 - 19岁、20 - 39岁、40 - 64岁和≥65岁）获取基于卫星的中午环境UVR。在相互调整和分层模型中估计UVB、UVA五分位数（Q）与首次原发性BCC和SCC之间关联的发病率比（IRR）和95%置信区间（CI），并额外调整了对阳光敏感的特征。

结果

基线时（1983 - 1998年）有62,595名年龄在22 - 90岁的非西班牙裔白人参与者。在中位25.5年的随访期间，报告了6339例新发BCC和1253例新发SCC。在相互调整之前，年度和夏季的UVB和UVA均与BCC和SCC风险呈正相关。调整UVA后，夏季（而非年度）UVB的Q5与Q1相比与BCC（IRR = 1.41；95% CI：1.13，1.77）和SCC（IRR = 1.69；95% CI：1.01，2.84）相关。调整UVB后，年度（而非夏季）UVA的Q5与Q1相比与BCC（IRR = 1.42；95% CI：1.13，1.77）和SCC（IRR = 1.84；95% CI：1.10，3.06）相关。