Association of nonmelanoma skin cancer and actinic keratosis with cumulative solar ultraviolet exposure in Maryland watermen

Abstract

To establish the relationship between ultraviolet-B radiation and squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and actinic keratosis (AK), a cross-sectional prevalence survey was performed in a sample of 808 white, male watermen 30 years of age and older residing in the Eastern Shore of Maryland. A measure of personal cumulative ultraviolet-B exposure was determined for each subject from data collected through interviews and field and laboratory measurements. A personal interview elicited skin type, medication history, and other factors. Clinical diagnoses and histologic confirmation were done for current and previously removed skin tumors. The ratio of subjects with SCC to subjects with BCC was approximately 1:1; however, the ratio of BCC to SCC was 1.25:l because BCC cases were more prone to multiple lesions. Watermen with SCC or AK but not BCC had higher average annual ultraviolet-B doses than age-matched controls. This was particularly marked in watermen younger than 60 years of age. Logistic regression showed that an older age, childhood freckling, and blue eyes significantly increased the risk of the development of all three types of skin tumor. Ease of sunburning was associated with BCC and AK, but not with SCC. Watermen in the upper quartile of cumulative ultraviolet-B exposure had a 2.5 times higher risk for the development of SCC when compared with the lower 3 quartiles. This suggests that high levels of ultraviolet-B exposure are important in SCC occurrence. The risk of AK developing was 1.5 times higher for those whose cumulative ultraviolet-B exposure exceeded the median. The relationship of BCC to cumulative ultraviolet-B exposure was not clear and this suggests that different etiologic mechanisms operate for SCC and BCC. Cancer 65:2811-2817,1990. From the

Multiple risk factors associated with arsenic-induced skin cancer: effects of chronic liver disease and malnutritional status

“…A positive association between sunlight exposure and skin cancer has been reported previously (Viyasa et al, 1990;Green and Battistutta, 1990) (Tam et al, 1979). Methylation of arsenic is considerd to be a detoxication mechanism because DMA has a low acute toxicity (Vahter and Marafante, 1983) and is rapidly excreted in the urine (Vahter et al, 1984).…”

Cutaneous Markers of Photo-Damage and Risk of Basal Cell Carcinoma of the Skin: A Meta-Analysis

“…In addition, report of exposure to the sun does not necessarily capture the relevant dose at a cellular level due to differences in skin type. There are several markers of chronic sun exposure, including actinic keratosis (24), elastosis, telangiectasia, and solar lentigines (25)(26)(27)(28) and assessment of the association between these and BCC provides a more objective measure of the impact of cumulative UVR exposure. Although there are studies that have explored this issue, there has been no previous attempt to synthesize this literature.…”

Repair Capacity for UV Light–Induced DNA Damage Associated with Risk of Nonmelanoma Skin Cancer and Tumor Progression

“…An early study of watermen from the eastern shore of Maryland found that average annual exposure to ambient UVB radiation was strongly correlated with the prevalence of SCC, whereas BCC did not have such a correlation (8), especially in watermen younger than 60 years of age (9). Because of the association between defects in DNA repair genes (10) and the poor DNA repair phenotype (11) that causes a high incidence of BCC and SCC in xeroderma pigmentosum (XP) patients (12), this watermen study provided much enthusiasm for further studying the DNA repair capacity (DRC) as a marker for genetic susceptibility to NMSC in the general population.…”