Journal Article

Cumulative solar ultraviolet radiation exposure and basal cell carcinoma of the skin in a nationwide US cohort using satellite and ground-based measures

Kimlin, Michael G., Little, Mark P., Linet, Martha S., Tatalovich, Zaria, Lee, Terrence, Sigurdson, Alice J., Cahoon, Elizabeth K.

2019

Overview

Background Basal cell carcinoma of the skin (BCC) is the most common cancer in populations of European ancestry. Although consistently linked with basal cell carcinoma of the skin in case-control studies, few prospective cohort studies have evaluated the shape of the exposure-response of basal cell carcinoma associated with cumulative radiant solar ultraviolet exposure (UVR). Methods We followed 63,912 white cancer-free US radiologic technologists from entry (1983–1998) to exit (2003–2005) with known ultraviolet irradiance at up to 5 residential locations. Using generalized-additive and relative risk models we analyzed the exposure-response of basal cell carcinomas associated with ambient cumulative ultraviolet radiant exposure using ground-based National Solar Radiation database Average Daily Total Global data and satellite-based National Aeronautics and Space Administration Total Ozone Mapping Spectrometer data. Results There were 2151 technologists with an incident primary basal cell carcinoma. Risk of basal cell carcinoma rose with increasing cumulative ultraviolet radiation exposure using both measures, such that 1 MJ cm − 2 increased basal cell carcinoma risk by 8.48 (95% CI 5.22, 11.09, p  < 0.001) and by 10.15 (95% CI 6.67, 13.10, p  < 0.001) per 10,000 persons per year using the Average Daily Total Global and Total Ozone Mapping Spectrometer ultraviolet data, respectively; relative risk was likewise elevated. There was some evidence of upward curvature in the cumulative ultraviolet exposure response using both exposure measures with a greater increase in risk of basal cell carcinoma at higher levels of ultraviolet radiation exposure, but less evidence for curvature in relative risk. There are indications of substantial variation of relative risk with time after exposure and age at exposure, so that risk is highest for the period 10–14 years after ultraviolet radiation exposure and for those exposed under the age of 25. Conclusions We observed increases in risk of basal cell carcinoma and a similar exposure-response for ground-based and satellite ultraviolet radiation measures. Our observations suggest that interventions should concentrate on persons with higher levels of ultraviolet radiation exposure.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / Aeronautics / Age / Aged / Analysis / Aviation / Basal cell carcinoma / Basal cell carcinoma of the skin / Cancer / Carcinoma / Carcinoma, Basal Cell - epidemiology / Carcinoma, Basal Cell - etiology / Child / Curvature / Dose-response effects / Earth and Environmental Science / Environment / Environmental Epidemiology / Environmental Exposure - adverse effects / Environmental Health / Estimates / Female / Humans / Incidence / Ionizing radiation / Irradiance / Male / Mapping / Medical records / Melanoma / Middle Aged / Non-ionizing radiation / Occupational Medicine/Industrial Medicine / Ozone / Population / Prospective Studies / Public Health / Questionnaires / Radiation (Physics) / Radiation effects / Radiation exposure / Radiation measurement / Radiologic technologist / Residential location / Risk analysis / Risk assessment / Satellites / Skin / Skin cancer / Skin Neoplasms - epidemiology / Skin Neoplasms - etiology / Solar radiation / Studies / Sunlight / Technologists / Total Ozone Mapping Spectrometer / Ultraviolet radiation / Ultraviolet Rays - adverse effects / Ultraviolet solar radiation / United States - epidemiology / Young Adult