Impact of residential UV exposure in childhood versus adulthood on skin cancer risk in Caucasian, postmenopausal women in the Women’s Health Initiative
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Sun exposure is a major risk factor for skin cancer; however, the relative contribution of ultraviolet (UV) exposure during childhood versus adulthood on skin cancer risk remains unclear.
Our goal was to determine the impact of residential UV, measured by AVerage daily total GLObal solar radiation (AVGLO), exposure during childhood (birth, 15 years) versus adulthood (35, 50 years, and present) on incident non-melanoma skin cancer (NMSC) and malignant melanoma (MM) in postmenopausal women.
Women were followed with yearly surveys throughout the duration of their participation in the Women’s Health Initiative Observational study, a multicenter study from 1993 to 2005. A total of 56,557 women had data on all observations and were included in the baseline characteristics. The main exposure, residential UV (as measured by AVGLO), was measured by geographic residence during childhood and adulthood. Outcome was risk of incident NMSC and MM.
Over 11.9 years (median follow-up), there were 9,195 (16.3 %) cases of NMSC and 518 (0.92 %) cases of MM. Compared with the reference group (women with low childhood and low adulthood UV), women with low childhood and high adulthood UV had a 21 % increased risk of NMSC (odds ratio 1.21, 95 % confidence interval 1.12, 1.31). Women with high childhood and high adulthood UV had a 19 % increased risk of NMSC (odds ratio 1.19, 95 % confidence interval 1.11, 1.27). Surprisingly, women with high childhood UV and low adulthood UV did not have a significant increase in NMSC risk compared with the reference group (odds ratio 1.08, 95 % confidence interval 0.91, 1.28) in multivariable models. Residential UV exposure in childhood or adulthood was not associated with increased melanoma risk.
This study reveals an increase in NMSC risk associated with adulthood residential UV exposure, with no effect for childhood UV exposure.
KeywordsSun exposure Ultraviolet radiation Skin cancer Basal cell carcinoma Squamous cell carcinoma Malignant melanoma Women’s Health Initiative
AVerage daily total GLObal solar radiation
Non-melanoma skin cancer
Basal cell carcinoma
Squamous cell carcinoma
Women’s Health Initiative
This study was supported in part by the Women’s Health Initiative program, which is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, and United States Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C.
Dr(s) Tang and Hedlin had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Ally and Stefanick were involved in study concept and design. Ransohoff, Ally, Stefanick, Hedlin, Kapphahn, and Tang were involved in acquisition, analysis, and interpretation of data. Ally, Ransohoff, and Tang drafted the manuscript. Ransohoff, Ally, Tang, Stefanick, Hedlin, Kapphahn, Keiser, Spaunhurst, Pagoto, Messina, and Manson were involved in critical revision of the manuscript for important intellectual content. Hedlin and Kapphahn were involved in statistical analysis. Tang obtained funding. Stefanick and Tang were involved in administrative, technical, or material support. Tang and Stefanick were involved in study supervision.
Compliance with ethical standards
Conflict of interest
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