Socioeconomic status and non-melanoma skin cancer: A nationwide cohort study of incidence and survival in Denmark

Steding-Jessen, Marianne; Birch-Johansen, Fatima; Jensen, Allan; Schüz, Joachim; Kjær, Susanne K.; Dalton, Susanne Oksbjerg

doi:10.1016/j.canep.2010.06.011

Cited by 64 publications

(53 citation statements)

References 13 publications

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“…Hence, the different associations between types of beverage and BCC may be due to characteristics of the users or unmeasured confounding. High socioeconomic status, measured as education and disposable income, is associated with a high risk for BCC (Steding-Jessen et al, 2010), and socioeconomic status is known to be a strong predictor of beverage preference (Tjonneland et al, 2003). Hence, although we adjusted our analyses for duration of education, we cannot rule out the possibility that the observed increased risk for BCC associated with wine and spirits but not with beer is due to residual confounding by socioeconomic status.…”

mentioning

confidence: 96%

Intake of Alcohol May Modify the Risk for Non-Melanoma Skin Cancer: Results of a Large Danish Prospective Cohort Study

Jensen

Birch-Johansen

Olesen

et al. 2012

Journal of Investigative Dermatology

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Alcohol has not been linked definitively to non-melanoma skin cancer. We examined whether alcohol intake affects the risks for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) using data on 54,766 persons enrolled in the prospective Diet, Cancer, and Health cohort. Statistical analyses were based on the Cox proportional hazards model. All hazard ratios (HRs) were multivariate adjusted. Adjustment for exposure to UVR was not possible, but all analyses were adjusted for factors related to susceptibility to UVR, including sun sensitivity, degree of freckling, and number of nevi. A total of 2,409 BCC cases and 198 SCC cases were diagnosed within a median follow-up of 11.4 years. Total current alcohol intake was not associated with BCC risk, but beverage-specific analyses showed an increased BCC risk associated with intake of wine (HR=1.05, 95% confidence interval (CI): 1.02-1.08, current average alcohol intake, per 10 g per day) and spirits (HR=1.11, 95% CI: 1.02-1.21) and a decreased risk with beer (HR=0.97, 95% CI: 0.93-1.00). No convincing associations were found between total alcohol intake and risk for SCC, perhaps because of the limited number of cases. Our findings indicate that alcohol intake may increase the risk for BCC, but the relations seemed to depend on beverage type.

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confidence: 96%

Intake of Alcohol May Modify the Risk for Non-Melanoma Skin Cancer: Results of a Large Danish Prospective Cohort Study

Jensen

Birch-Johansen

Olesen

et al. 2012

Journal of Investigative Dermatology

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“…That study also showed that another form of NMSC, squamous cell carcinoma, is weakly associated with higher income, but not education. 16 Lower education is associated with reduced reporting of medical illness. 17 These baseline cognitive differences suggest that NMSC might be a marker for a factor or factors that protect against the development of AD.…”

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confidence: 99%

Nonmelanoma skin cancer is associated with reduced Alzheimer disease risk

et al. 2013

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Objective: To explore the association of nonmelanoma skin cancer (NMSC) and Alzheimer disease (AD) in the Einstein Aging Study, an epidemiologic study of aging in New York City.Methods: Community-residing volunteers aged 70 years or older were assessed annually, followed by multidisciplinary diagnostic consensus. Cancer status and type was obtained by self-report. Cox proportional hazards models were used to test associations between NMSC and subsequent risk of developing a neurocognitive disorder. To deduce a biologically specific association between AD and NMSC, we considered 3 nested outcomes groups: only AD (probable or possible AD as the sole diagnosis), any AD (probable AD or possible AD, as well as mixed AD/ vascular dementia), and all-cause dementia.Results: We followed 1,102 adults with a mean age of 79 years at enrollment. Prevalent NMSC was associated with reduced risk of only AD (hazard ratio 5 0.21; 95% confidence interval 5 0.051-0.87; p 5 0.031) among subjects after adjustment for demographics, hypertension, diabetes, and coronary heart disease. APOE e4 genotypes were available in 769 individuals. The association was similar in magnitude, but nonsignificant, when the number of APOE e4 alleles was included in the model. No significant association was found between NMSC and subsequent development of any AD or all-cause dementia.Conclusions: This population-based longitudinal study shows that individuals older than 70 years with NMSC have a significantly reduced risk of developing AD compared with individuals without NMSC. We deduce Alzheimer-specific neuroprotection, because the effect is attenuated or eliminated when considering less-specific diagnoses such as AD with another diagnosis (any AD) or all-cause dementia. Previous studies observed an inverse relationship between Alzheimer disease (AD) and cancer. The Washington University AD Research Center showed reduced incidence of cancer in participants with prevalent AD, and a nonsignificant trend toward lower incidence of AD in persons with history of cancer at baseline.

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“…This is more likely going to reflect different patterns of sun exposure related to socio-economic status as opposed to neglect and late medical attention. 28 In contrast, this study is based on a significantly smaller sample size. However, it does offer a more complete picture of socio-economic deprivation through the SIMD scores encompassing 37 indicators of deprivation, for which the authors are the first to apply to patients with periocular BCC.…”

Section: Discussionmentioning

confidence: 86%

The Effect of Socio-Economic Status on Severity of Periocular Basal Cell Carcinoma at Presentation

Lim

Agarwal

Young

et al. 2015

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Socioeconomic status and non-melanoma skin cancer: A nationwide cohort study of incidence and survival in Denmark

Cited by 64 publications

References 13 publications

Intake of Alcohol May Modify the Risk for Non-Melanoma Skin Cancer: Results of a Large Danish Prospective Cohort Study

Intake of Alcohol May Modify the Risk for Non-Melanoma Skin Cancer: Results of a Large Danish Prospective Cohort Study

Nonmelanoma skin cancer is associated with reduced Alzheimer disease risk

The Effect of Socio-Economic Status on Severity of Periocular Basal Cell Carcinoma at Presentation

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