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Wu S, Han J, Laden F, Qureshi AA. Long-term ultraviolet flux, other potential risk factors, and skin cancer risk: a cohort study. Cancer Epidemiol Biomarkers Prev 2016; 23:1080-9. [PMID: 24876226 DOI: 10.1158/1055-9965.epi-13-0821] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Few prospective studies have examined the relationship between sun exposure, other potential risk factors, and risk of different skin cancers [including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma] simultaneously. METHODS We evaluated the association between a number of potential risk factors and skin cancer risk in a cohort of 108,916 US women, the Nurses' Health Study II (1989-2009). RESULTS During 2.05 million years of follow-up, we identified 6,955, 880, and 779 diagnoses of BCC, SCC, and melanoma, respectively. Compared with participants in the lowest quintile of cumulative ultraviolet flux in adulthood, participants in the highest quintile had multivariable-adjusted relative risks (RR) of 2.35 (Ptrend < 0.0001) for BCC, 2.53 (Ptrend = 0.009) for SCC, and 0.68 (Ptrend = 0.38) for melanoma. In contrast, the RRs were 1.68 (95% CI, 1.55-1.82) for BCC, 1.68 (95% CI, 1.34-2.11) for SCC, and 1.80 (95% CI, 1.42-2.28) for melanoma for participants with ≥5 blistering sunburns when compared with participants without sunburn between ages 15 and 20 years. We found significant interactions between family history of melanoma, number of blistering sunburns between ages 15 and 20 years and BCC risk, and between sunburn reaction as a child/adolescent and SCC risk (all Pinteraction < 0.05). CONCLUSION In a cohort of U.S. women, we found that sun exposures in both early life and adulthood were predictive of BCC and SCC risks, whereas melanoma risk was predominantly associated with sun exposure in early life. IMPACT Our results may have potential implications for the prevention of skin cancers. Cancer Epidemiol Biomarkers Prev; 23(6); 1080-9. ©2014 AACR.
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Affiliation(s)
- Shaowei Wu
- Authors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode IslandAuthors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jiali Han
- Authors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode IslandAuthors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode IslandAuthors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode IslandAuthors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Br
| | - Francine Laden
- Authors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode IslandAuthors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode IslandAuthors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Abrar A Qureshi
- Authors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode IslandAuthors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode IslandAuthors' Affiliations: Department of Dermatology; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School; Departments of Epidemiology and Environmental Health, Harvard School of Public Health, Boston, Massachusetts; Department of Epidemiology, Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana; and Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Madronich S, McKenzie RL, Björn LO, Caldwell MM. Changes in biologically active ultraviolet radiation reaching the Earth's surface. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 1998; 46:5-19. [PMID: 9894350 DOI: 10.1016/s1011-1344(98)00182-1] [Citation(s) in RCA: 643] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Stratospheric ozone levels are near their lowest point since measurements began, so current ultraviolet-B (UV-B) radiation levels are thought to be close to their maximum. Total stratospheric content of ozone-depleting substances is expected to reach a maximum before the year 2000. All other things being equal, the current ozone losses and related UV-B increases should be close to their maximum. Increases in surface erythemal (sunburning) UV radiation relative to the values in the 1970s are estimated to be: about 7% at Northern Hemisphere mid-latitudes in winter/spring; about 4% at Northern Hemisphere mid-latitudes in summer/fall; about 6% at Southern Hemisphere mid-latitudes on a year-round basis; about 130% in the Antarctic in spring; and about 22% in the Arctic in spring. Reductions in atmospheric ozone are expected to result in higher amounts of UV-B radiation reaching the Earth's surface. The expected correlation between increases in surface UV-B radiation and decreases in overhead ozone has been further demonstrated and quantified by ground-based instruments under a wide range of conditions. Improved measurements of UV-B radiation are now providing better geographical and temporal coverage. Surface UV-B radiation levels are highly variable because of cloud cover, and also because of local effects including pollutants and surface reflections. These factors usually decrease atmospheric transmission and therefore the surface irradiances at UV-B as well as other wavelengths. Occasional cloud-induced increases have also been reported. With a few exceptions, the direct detection of UV-B trends at low- and mid-latitudes remains problematic due to this high natural variability, the relatively small ozone changes, and the practical difficulties of maintaining long-term stability in networks of UV-measuring instruments. Few reliable UV-B radiation measurements are available from pre-ozone-depletion days. Satellite-based observations of atmospheric ozone and clouds are being used, together with models of atmospheric transmission, to provide global coverage and long-term estimates of surface UV-B radiation. Estimates of long-term (1979-1992) trends in zonally averaged UV irradiances that include cloud effects are nearly identical to those for clear-sky estimates, providing evidence that clouds have not influenced the UV-B trends. However, the limitations of satellite-derived UV estimates should be recognized. To assess uncertainties inherent in this approach, additional validations involving comparisons with ground-based observations are required. Direct comparisons of ground-based UV-B radiation measurements between a few mid-latitude sites in the Northern and Southern Hemispheres have shown larger differences than those estimated using satellite data. Ground-based measurements show that summertime erythemal UV irradiances in the Southern Hemisphere exceed those at comparable latitudes of the Northern Hemisphere by up to 40%, whereas corresponding satellite-based estimates yield only 10-15% differences. Atmospheric pollution may be a factor in this discrepancy between ground-based measurements and satellite-derived estimates. UV-B measurements at more sites are required to determine whether the larger observed differences are globally representative. High levels of UV-B radiation continue to be observed in Antarctica during the recurrent spring-time ozone hole. For example, during ozone-hole episodes, measured biologically damaging radiation at Palmer Station, Antarctica (64 degrees S) has been found to approach and occasionally even exceed maximum summer values at San Diego, CA, USA (32 degrees N). Long-term predictions of future UV-B levels are difficult and uncertain. Nevertheless, current best estimates suggest that a slow recovery to pre-ozone depletion levels may be expected during the next half-century. (ABSTRACT TRUNCATED)
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Affiliation(s)
- S Madronich
- National Center for Atmospheric Research, Atmospheric Chemistry Division, Boulder, CO 80307-3000, USA.
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