Rosso S, Zanetti R, Martinez C, Tormo M J, Schraub S, Sancho-Garnier H, Franceschi S, Gafà L, Perea E, Navarro C, Laurent R, Schrameck C, Talamini R, Tumino R, Wechsler J
Registro de Càncer de Granada, Escuela Andaluza de Salud Publica, Spain.
Br J Cancer. 1996 Jun;73(11):1447-54. doi: 10.1038/bjc.1996.275.
The role of sun exposure in development of basal cell and squamous cell carcinomas among different populations from south Europe was investigated. Between 1989 and 1993 we interviewed incident cases and a random population sample of controls from five centres where a cancer registry was operating, whereas we selected a sample of hospital-based cases and controls from the other three centres. We gathered information on life-long exposure to sunlight during different activities. Results are analysed for 1549 basal cell carcinoma (BCC) cases and 228 squamous cell carcinoma (SCC) cases compared with 1795 controls. We observed a statistically significant increase of risk of SCC with increasing sun exposure beyond a threshold of 70,000 cumulated hours of exposure in a lifetime. Sun exposures during work and holidays were, however, inversely correlated. Odds ratios (ORs) of SCC were up to eight or nine times the reference for the highest exposures (200,000 cumulated hours or more). BCC exhibited a 2-fold increase of risk for lower exposure (8000-10,000 cumulated hours in a lifetime) with a plateau and a slight decrease of risk for the highest exposures (100,000 cumulated hours or more). Outdoor work showed a significantly increased risk of SCC (OR 1.6 for more than 54,000 cumulated hours of exposure in a lifetime), whereas recreational activities such as sun exposure during holidays at the beach (OR 1.6 for more than 2600 cumulated hours of exposure in a lifetime) or during water sports (OR 1.6 for more than 2600 cumulated hours of exposure in a lifetime) were associated with an increased risk of BCC. Risk patterns were different in poor or good tanners with a significant risk trend for good tanners, whereas poor tanners were on a plateau of increased risk at any level of exposure. Solar radiation is associated with a risk of BCC even for relatively short periods of exposure such as during holidays and sports, whereas SCC develops later if exposure continues. The skin's ability to tan modulates the risk of BCC; subjects who tan poorly have a steady risk increase, whereas people who tan easily develop cancer only after prolonged exposures.
研究了阳光照射在南欧不同人群基底细胞癌和鳞状细胞癌发生中的作用。1989年至1993年间，我们对来自五个设有癌症登记处的中心的新发病例和随机抽取的对照人群样本进行了访谈，而从其他三个中心选取了以医院为基础的病例和对照样本。我们收集了不同活动期间终生阳光照射的信息。对1549例基底细胞癌（BCC）病例和228例鳞状细胞癌（SCC）病例以及1795例对照的结果进行了分析。我们观察到，一生中累计暴露时间超过70000小时的阈值后，随着阳光照射增加，SCC风险有统计学意义的增加。然而，工作和假期期间的阳光照射呈负相关。SCC的比值比（OR）高达最高暴露水平（200000累计小时或更多）参考值的八到九倍。BCC在较低暴露水平（一生中累计8000 - 10000小时）时风险增加两倍，之后趋于平稳，在最高暴露水平（100000累计小时或更多）时风险略有下降。户外工作显示SCC风险显著增加（一生中累计暴露超过54000小时的OR为1.6），而诸如在海滩度假时晒太阳（一生中累计暴露超过2600小时的OR为1.6）或进行水上运动时晒太阳（一生中累计暴露超过2600小时的OR为1.6）等娱乐活动与BCC风险增加有关。在皮肤晒黑能力差或好的人群中风险模式不同，皮肤晒黑能力好的人群有显著的风险趋势，而皮肤晒黑能力差的人群在任何暴露水平下风险都处于升高的平稳状态。即使是相对较短的暴露时间，如假期和运动期间，太阳辐射也与BCC风险相关，而如果持续暴露，SCC会在后期发生。皮肤晒黑的能力调节BCC风险；皮肤晒黑能力差的受试者风险持续增加，而容易晒黑的人只有在长期暴露后才会患癌。
