Weber Isaac, Liao Kaiping, Dang Tran, Shah Malay, Wehner Mackenzie R
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston.
Johns Hopkins School of Medicine, Baltimore, Maryland.
JAMA Dermatol. 2025 Sep 24. doi: 10.1001/jamadermatol.2025.3473.
While UV radiation is a known carcinogen associated with cutaneous squamous cell carcinoma (cSCC), sunburn's specific role remains less clear.
To quantitatively assess the association between sunburn history and the risk of developing cSCC.
A comprehensive search of Embase, PubMed, and Cochrane Library (CENTRAL) was conducted from inception up to May 6, 2025, with no language or date restrictions. Search terms included Non melanoma skin cancer or nonmelanoma skin cancer or NMSC or squamous cell carcinoma or SCC or cSCC or Bowen disease and Sunburn or sun exposure or sunlight or sun damage or ultraviolet radiation or ultraviolet light or ultraviolet rays.
The study included analytical investigations of the general population that assessed the association between cSCC and any type of sunburn history at any age. The initial screening of 9310 titles and abstracts by 3 masked independent reviewers resulted in 279 articles for full-text review, with 43 ultimately meeting eligibility criteria.
This study follows the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline. Two reviewers worked independently to extract relevant data. The random effects DerSimonian-Laird method was used to pool data.
The main outcome was the risk of developing cSCC. Main measures included sunburn frequency (both undefined and painful, blistering, and/or severe) in any life period, categorized into ordinal variables: none, low, medium, and high. The primary analysis was the most adjusted measure of association, standardized to odds ratio (OR). This incorporated adjusted measures of association when available and unadjusted measures when adjusted measures were absent.
Seventeen studies with a combined 321 473 participants were included in the meta-analysis. Pooled analyses of the most adjusted results revealed significantly increased odds of developing cSCC with medium (OR, 1.51; 95% CI, 1.26-1.81) and high (OR, 1.69; 95% CI, 1.39-2.06) lifetime painful, blistering, and/or severe sunburn frequencies. Similarly, high frequencies of painful, blistering, and/or severe sunburns in childhood were significantly associated with increased cSCC odds (OR, 3.11; 95% CI, 1.26-7.66). A history of any painful, blistering, and/or severe sunburn was also significantly associated with increased odds of cSCC (OR, 1.38; 95% CI, 1.06-1.79).
This meta-analysis supports an association between painful, blistering, and/or severe sunburns and cSCC.
虽然紫外线辐射是一种已知的与皮肤鳞状细胞癌（cSCC）相关的致癌物，但晒伤的具体作用仍不太明确。
定量评估晒伤史与发生cSCC风险之间的关联。
对Embase、PubMed和Cochrane图书馆（CENTRAL）进行了全面检索，检索时间从建库至2025年5月6日，无语言或日期限制。检索词包括非黑色素瘤皮肤癌或非黑素瘤皮肤癌或NMSC或鳞状细胞癌或SCC或cSCC或鲍恩病以及晒伤或阳光暴露或日光或阳光损伤或紫外线辐射或紫外线或紫外线射线。
该研究包括对一般人群的分析性调查，评估了任何年龄的cSCC与任何类型晒伤史之间的关联。由3名独立的盲法评审员对9310篇标题和摘要进行初步筛选，结果有279篇文章进行全文评审，最终43篇符合纳入标准。
本研究遵循流行病学观察性研究的Meta分析（MOOSE）报告指南。两名评审员独立工作以提取相关数据。采用随机效应DerSimonian-Laird方法汇总数据。
主要结局是发生cSCC的风险。主要指标包括任何生命阶段的晒伤频率（包括未明确的以及疼痛、起泡和/或严重的晒伤），分为有序变量：无、低、中、高。主要分析是最具调整性的关联度量，标准化为比值比（OR）。这包括在有可用调整关联度量时采用调整后的度量，在没有调整度量时采用未调整的度量。
17项研究共纳入321473名参与者，进行了Meta分析。对最具调整性结果的汇总分析显示，终生疼痛、起泡和/或严重晒伤频率为中等（OR，1.51；95%CI，1.26 - 1.81）和高（OR，1.69；95%CI，1.39 - 2.06）时，发生cSCC的几率显著增加。同样，儿童期疼痛、起泡和/或严重晒伤频率高与cSCC几率增加显著相关（OR，3.11；95%CI，1.26 - 7.66）。任何疼痛、起泡和/或严重晒伤史也与cSCC几率增加显著相关（OR，1.38；95%CI，1.06 - 1.79）。
这项Meta分析支持疼痛、起泡和/或严重晒伤与cSCC之间存在关联。
