Zanetti R, Tumino R
Centro per la Prevenzione Oncologica della Regione Piemonte, Registro Tumori Piemonte, Torino.
Med Lav. 1998 Mar-Apr;89(2):142-8.
In the evaluation expressed by the IARC Monographs, solar radiation is recognised to be carcinogenic to man. The principal risk factors for skin cancers are personal characteristics such as fair complexion or tendency to burn. After controlling for these factors, an association remains with exposure to solar radiation, with different patterns for various types of skin cancer. For cutaneous malignant melanoma (CMM) the evidence is based on the results of two dozen case-control studies which showed a significant positive association for intermittent exposure (overall OR: 1.7), a reduced risk for heavy occupational exposure (OR: 0.8) and an increased risk with sunburns (OR: 1.9). For basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) the evidence is based on experimental results in animals, on descriptive studies (mainly body location and geographical distribution) and on a few case-control studies. The risk pattern of BCC is similar to that for CMM, with increased risk for intermediate levels of cumulative exposure and a protection associated with higher levels. Contrary wise, low and intermediate cumulative doses have no effect on the risk of SCC, which increases exponentially with very high doses like those corresponding to a lifelong outdoor occupational exposure.
在国际癌症研究机构专论所表达的评估中，太阳辐射被认为对人类具有致癌性。皮肤癌的主要风险因素是个人特征，如肤色白皙或容易晒伤。在控制这些因素后，太阳辐射暴露与皮肤癌之间仍存在关联，不同类型的皮肤癌有不同的模式。对于皮肤恶性黑色素瘤（CMM），证据基于二十多项病例对照研究的结果，这些研究表明间歇性暴露存在显著正相关（总体比值比：1.7），重度职业暴露风险降低（比值比：0.8），晒伤风险增加（比值比：1.9）。对于基底细胞癌（BCC）和鳞状细胞癌（SCC），证据基于动物实验结果、描述性研究（主要是身体部位和地理分布）以及一些病例对照研究。BCC的风险模式与CMM相似，累积暴露处于中等水平时风险增加，而高水平暴露则具有保护作用。相反，低剂量和中等剂量的累积暴露对SCC风险没有影响，SCC风险会随着极高剂量（如终生户外职业暴露所对应的剂量）呈指数增长。
