Skin cancers, though rare in Japan, have reportedly been on the rise, but little else is known about epidemiologic features of different histologic types of skin cancer. The Life Span Study cohort, which consists of 93,700 atomic-bomb survivors, many of whom were exposed to negligibly low radiation doses, and 26,600 people not exposed to radiation, enables a population-based study of spontaneous as well as radiation-related cancer risk. Skin tumor incident cases diagnosed between 1958 and 1987 were ascertained by linkage to the Hiroshima and Nagasaki tumor registries augmented by searches of other data sources. Study pathologists reviewed tumor specimens and pathology reports and classified tumors using the World Health Organization classification scheme. They identified 274 primary incident skin cancers, of which 106 were basal cell carcinoma (BCC), 81 were squamous cell carcinoma (SCC), and 14 were malignant melanomas. Background incidence rates and radiation effects were assessed by Poisson regression models allowing for the effects of demographic and other covariates. BCC and SCC background incidence rates were both about 3 per 100,000 per year. BCCs were mainly on the head/neck (81%), whereas SCCs occurred most frequently on the arms/legs (45%) and head/neck (29%), consistent with the presumed role played by solar UV exposure in skin cancer. The BCC rates increased significantly between 1958 and 1987, whereas the SCC rates remained unchanged. The excess absolute risk of BCC per unit skin surface area related to atomic-bomb radiation exposure did not differ between UV-exposed and shielded parts of the body, suggesting the additivity of the radiation-related and background BCC risks. ' 2005 Wiley-Liss, Inc.Key words: basal cell carcinoma of the skin; squamous cell carcinoma of the skin; ionizing radiation; sun exposure Skin cancers are relatively rare in Japan. Age-adjusted incidence rates (per 10 5 per year) of melanoma are 0.2-0.5 in Japan compared to that of 10-20 in US whites and 30-40 in Australia.
1The incidence rates of about 1.0-5.5 for NMSC in Japan are much lower than US white rates of about 250.1,2 UV radiation is the major cause of skin cancer, involving all 3 major types: BCC, SCC and melanoma in fair-skinned Caucasian populations. 3,4 Except for the reportedly rising incidence of melanoma and BCC of the skin, 5,6 there have been little epidemiologic data on characteristics of skin cancer in Japan, especially by histologic types.IR has long been known to cause skin cancer, especially BCC, 3,4,7 and we previously reported the IR effect on BCC in the LSS cohort of atomic bomb survivors and controls.8 A large number of subjects (more than 57,000 or 51%) in this cohort were not or were only negligibly exposed (i.e., at <5 mSv) to radiation from the atomic bombs. This enabled us to analyze the background cancer rates by histologic type, taking advantage of the long-term cancer incidence follow-up.In our study, we describe the epidemiologic characteristics of background rates for the different histolog...