NDLI: Incidence of Nonmelanoma Skin Cancer in Relation to Ambient UV Radiation in White Populations, 1978-2012: Empirical Relationships

Content Provider	JAMA Network
Author	Xiang, Fan Lucas, Robyn Hales, Simon Neale, Rachel
Copyright Year	2014
Abstract	Importance: Nonmelanoma skin cancers ( NMSCs) are the most common cancers in fair-skinned populations. Their incidence continues to increase in many countries. Exposure to UV radiation ( UVR) is the primary cause of NMSC, although the pattern of exposure that gives rise to different types of NMSC appears to vary. Objective: To examine dose-response relationships between ambient UVR levels and NMSC incidence at the population level. Design, Setting, and Participants: Peer-reviewed literature published from January 1, 1978, through December 31, 2012, that provided age- and sex-specific incidence of NMSC in white populations worldwide was systematically reviewed. Exposures: Mean erythemally weighted daily ambient UVR levels for each study location were derived from satellite data. Main Outcomes and Measures: The incidence of NMSC in white populations worldwide as reported in population-based studies. Results: Forty eligible publications were included in the analysis. Analysis models that contained age group, sex, study year, mean daily UVR, and day-to-day variability of UVR explained most of the variability in NMSC incidence: 82% for basal cell carcinoma ( BCC) and 85% for squamous cell carcinoma ( SCC). Exclusion of studies in which imputation of age-specific incidence data from standardized rates was required improved the model fit to 85% for BCC and 88% for SCC. Higher mean daily UVR was associated with higher NMSC incidence rates; this was greater in men than women for BCC (70% vs 60%) but greater in women for SCC (99% vs 92%). Incidence rates for BCC and SCC were higher among those older than 60 years, but the increase with age was steeper for those younger than 60 years. Conclusions and Relevance: Our models highlight the etiologic differences between BCC and SCC and allow prediction of NMSC incidence for data-poor regions and under changing demographic and environmental conditions.
Ending Page	1071
Starting Page	1063
Page Count	9
File Format	PDF HTM / HTML
ISSN	21686068
DOI	10.1001/jamadermatol.2014.762
Issue Number	10
Journal	JAMA Dermatology
Volume Number	150
Language	English
Publisher	American Medical Association
Publisher Date	2014-10-01
Access Restriction	Open
Subject Keyword	statistical models ultraviolet rays projections and predictions skin carcinoma squamous cell carcinoma drug dose-response relationship basal cell carcinoma skin cancer cancer imputation
Content Type	Text
Resource Type	Article
Subject	Dermatology

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