Impact of residential UV exposure in childhood versus adulthood on skin cancer risk in Caucasian, postmenopausal women in the Women's Health Initiative

Katherine J Ransohoff; Mina S Ally; Marcia L Stefanick; Elizabeth Keiser; Katrina Spaunhurst; Kristopher Kapphahn; Sherry Pagoto; Catherine Messina; Haley Hedlin; JoAnn E Manson; Jean Y Tang

doi:10.1007/s10552-016-0730-9

Impact of residential UV exposure in childhood versus adulthood on skin cancer risk in Caucasian, postmenopausal women in the Women's Health Initiative

Cancer Causes Control. 2016 Jun;27(6):817-23. doi: 10.1007/s10552-016-0730-9. Epub 2016 May 6.

Authors

Affiliations

¹ Department of Dermatology, Stanford University School of Medicine, 450 Broadway - Pavilion C, Redwood City, CA, USA.
² Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
³ UCSD School of Medicine, La Jolla, CA, USA.
⁴ Department of Dermatology, Case Western Reserve, Cleveland, OH, USA.
⁵ Department of Medicine, Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, USA.
⁶ Department of Medicine, University of Massachusetts Medical School, Boston, MA, USA.
⁷ Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY, USA.
⁸ Department of Medicine, Brigham and Women's, Boston, MA, USA.
⁹ Department of Dermatology, Stanford University School of Medicine, 450 Broadway - Pavilion C, Redwood City, CA, USA. tangy@stanford.edu.

PMID: 27153844
DOI: 10.1007/s10552-016-0730-9

Abstract

Background: 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.

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: This study reveals an increase in NMSC risk associated with adulthood residential UV exposure, with no effect for childhood UV exposure.

Keywords: Basal cell carcinoma; Malignant melanoma; Skin cancer; Squamous cell carcinoma; Sun exposure; Ultraviolet radiation; Women’s Health Initiative.

Publication types

Observational Study
Research Support, N.I.H., Extramural

MeSH terms

Age Factors
Aged
Carcinoma, Basal Cell / epidemiology*
Carcinoma, Squamous Cell / epidemiology*
Environmental Exposure / statistics & numerical data*
Female
Humans
Melanoma / epidemiology*
Middle Aged
Odds Ratio
Postmenopause
Risk Factors
Skin Neoplasms / epidemiology*
Ultraviolet Rays*
White People*
Women's Health