1
|
Lashway SG, Worthen ADM, Abuasbeh JN, Harris RB, Farland LV, O'Rourke MK, Dennis LK. A meta-analysis of sunburn and basal cell carcinoma risk. Cancer Epidemiol 2023; 85:102379. [PMID: 37201363 DOI: 10.1016/j.canep.2023.102379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
Basal cell carcinoma (BCC) is the most common cancer in the United States. Sunburn is a modifiable risk factor for BCC. The objective of this project was to synthesize research on BCC and sunburn to quantify the impact and severity of sunburn at different life stages on BCC risk in the general population. A systematic literature search of four electronic databases was conducted and data were extracted by two independent reviewers using standardized forms. Data from 38 studies were pooled using both dichotomous and dose-response meta-analytic methods. BCC risk increased with ever experiencing a sunburn in childhood (OR=1.43, 95% CI: 1.19, 1.72) and with ever experiencing a sunburn in life (OR= 1.40, 95% CI: 1.02, 1.45). Every five sunburns experienced per decade in childhood increased BCC risk by 1.86 (95% CI: 1.73, 2.00) times. Every five sunburns experienced per decade in adulthood increased BCC risk by 2.12 (95% CI: 1.75, 2.57) times and every five sunburns per decade of life increased BCC risk by 1.91 (95% CI: 1.42, 2.58) times. The data on sunburn exposure and BCC show that an increase in number of sunburns at any age increased the risk of BCC. This may inform future prevention efforts.
Collapse
Affiliation(s)
- Stephanie G Lashway
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Aimee D M Worthen
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Jumanah N Abuasbeh
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Mary Kay O'Rourke
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA
| |
Collapse
|
2
|
Frankel L, Ardeljan AD, Takabe K, Rashid OM. The Association Between Aspirin and Basal Cell Carcinoma: A Clinical and Financial Analysis. World J Oncol 2022; 13:343-349. [PMID: 36660204 PMCID: PMC9822678 DOI: 10.14740/wjon1533] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/05/2022] [Indexed: 12/26/2022] Open
Abstract
Background Nonmelanoma skin cancer (NMSC) is the most common malignancy. Basal cell carcinoma (BCC) comprises about 80% of all NMSCs and its incidence continues to rise. Although BCC rarely leads to metastases or increased mortality, its effects on healthcare costs and quality of life are substantial. Aspirin may prevent the development of basal cell carcinoma (BCC) by the inhibition of cyclooxygenase (COX) enzymes, which are associated with carcinogenesis and inflammation. This study therefore examined the effect of aspirin on the risk of BCC, its clinical outcomes, and its treatment costs. Methods A retrospective study (2010 - 2018) was conducted using the Humana Health Insurance Database. International Classification of Disease ninth and 10th codes and National Drug Codes were used to identify BCC diagnoses and aspirin prescriptions. Patients were matched for age, sex, Charlson Comorbidity Score (CCI), and region of residence. Chi-squared, logistic regression, and odds ratio (OR) analyses were utilized to test for significance and to estimate relative risk. Results Aspirin use was associated with a decreased incidence of BCC in unmatched (OR = 0.658, 95% confidence interval (CI) 0.526 - 0.820) and matched (OR = 0.54, 95% CI 0.47 - 0.61) analyses. Aspirin was also associated with a decreased BCC risk when stratified by hypertension (P = 3.888 × 10-5), chronic obstructive pulmonary disease (COPD) (P = 0.014), diabetes (P = 0.049) and tobacco use (P = 0.017). Aspirin use was not associated with risk of BCC when stratified by obesity (P = 0.408). The average paid per patient for BCC treatment was significantly higher for patients in the aspirin use group than in the aspirin nonuse group (P = 0.0087). Conclusions While the high incidence and cost of treatment of BCC are demanding both clinically and financially, the low cost of aspirin and its widespread use may have vital implications for its preventative role in this disease. This study concluded that aspirin use was associated with a significantly decreased risk of BCC.
Collapse
Affiliation(s)
- Lexi Frankel
- Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA
| | - Amalia D. Ardeljan
- Michael and Dianne Biennes Comprehensive Cancer Center, Holy Cross Health, Fort Lauderdale, FL, USA
| | - Kazuaki Takabe
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA,Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, NY, USA
| | - Omar M. Rashid
- Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, FL, USA,Michael and Dianne Biennes Comprehensive Cancer Center, Holy Cross Health, Fort Lauderdale, FL, USA,Leonard Miami School of Medicine, University of Miami, Miami, FL, USA,Massachusetts General Hospital, Boston, MA, USA,Broward Health, Fort Lauderdale, FL, USA,TopLine MD Alliance, Fort Lauderdale, FL, USA,Memorial Health, Pembroke Pines, FL, USA,Delray Medical Center, Delray, FL, USA,Corresponding Author: Omar M. Rashid, Complex General Surgical Oncology, General & Robotic Surgery, TopLine MD Alliance, Fort Lauderdale, FL 33308, USA.
| |
Collapse
|
3
|
Little MP, Lee T, Kimlin MG, Kitahara CM, Zhang R, Alexander BH, Linet MS, Cahoon EK. Lifetime Ambient UV Radiation Exposure and Risk of Basal Cell Carcinoma by Anatomic Site in a Nationwide U.S. Cohort, 1983-2005. Cancer Epidemiol Biomarkers Prev 2021; 30:1932-1946. [PMID: 34289968 DOI: 10.1158/1055-9965.epi-20-1815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/31/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cutaneous basal cell carcinoma (BCC) has long been associated with UV radiation (UVR) exposure, but data are limited on risks by anatomic site. METHODS We followed 63,912 cancer-free White U.S. radiologic technologists from cohort entry (1983-1989/1994-1998) to exit (date first BCC via 2003-2005 questionnaire). We estimated associations between cumulative ambient UVR and relative/absolute risks of self-reported BCC by anatomic location via Poisson models. RESULTS For incident first primary BCC in 2,124 subjects (mean follow-up, 16.9 years) log[excess relative risks] (ERR) of BCC per unit cumulative ambient UVR = 1.27/MJ cm-2 [95% confidence interval (CI): 0.86-1.68; P trend < 0.001] did not vary by anatomic site (P = 0.153). However, excess absolute risks of BCC per unit cumulative ambient UVR were large for the head/neck = 5.46/MJ cm-2/104 person-year (95% CI: 2.92-7.36; P trend < 0.001), smaller for the trunk (2.56; 95% CI: 1.26-3.33; P trend = 0.003), with lesser increases elsewhere. There were lower relative risks, but higher absolute risks, for those with Gaelic ancestry (P < 0.001), also higher absolute risks among those with fair complexion, but relative and absolute risks were not generally modified by other constitutional, lifestyle or medical factors for any anatomic sites. Excess absolute and relative risk was concentrated 5-15 years before time of follow-up. CONCLUSIONS BCC relative and absolute risk rose with increasing cumulative ambient UVR exposure, with absolute risk highest for the head/neck, to a lesser extent in the trunk. IMPACT These associations should be evaluated in other White and other racial/ethnic populations along with assessment of possible modification by time outdoors, protective, and behavioral factors.
Collapse
Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland.
| | - Terrence Lee
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Michael G Kimlin
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Rui Zhang
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| |
Collapse
|
4
|
Quiñones OG, Pierre MBR. Cutaneous Application of Celecoxib for Inflammatory and Cancer Diseases. Curr Cancer Drug Targets 2020; 19:5-16. [PMID: 29714143 DOI: 10.2174/1568009618666180430125201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/31/2018] [Accepted: 03/03/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Nonsteroidal anti-inflammatory drugs (NSAIDs) and particularly selective cyclooxygenase-2 (COX-2) inhibitors such as celecoxib (Cxb) are considered promising cancer chemopreventive for colon, breast, prostate, lung, and skin cancers. However, the clinical application to the prevention is limited by concerns about safety, potential to serious toxicity (mainly for healthy individuals), efficacy and optimal treatment regimen. Cxb exhibits advantages as potent antiinflammatory and gastrointestinal tolerance compared with conventional NSAID's. Recent researches suggest that dermatological formulations of Cxb are more suitable than oral administration in the treatment of cutaneous disease, including skin cancer. To date, optimism has been growing regarding the exploration of the topical application of Cxb (in the prevention of skin cancers and treatment of cutaneous inflammation) or transdermal route reducing risks of systemic side effects. OBJECTIVE This paper briefly summarizes our current knowledge of the development of the cutaneous formulations or delivery systems for Cxb as anti-inflammatory drug (for topical or transdermal application) as well its chemopreventive properties focused on skin cancer. CONCLUSION New perspectives emerge from the growing knowledge, bringing innovative techniques combining the action of Cxb with other substances or agents which act in a different way, but complementary, increasing the efficacy and minimizing toxicity.
Collapse
Affiliation(s)
- Oliesia Gonzalez Quiñones
- School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, 21.941.902, Rio de Janeiro, RJ, Brazil
| | - Maria Bernadete Riemma Pierre
- School of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho 373, 21.941.902, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
5
|
Ma Y, Yu P, Lin S, Li Q, Fang Z, Huang Z. The association between nonsteroidal anti-inflammatory drugs and skin cancer: Different responses in American and European populations. Pharmacol Res 2019; 152:104499. [PMID: 31689521 DOI: 10.1016/j.phrs.2019.104499] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 10/02/2019] [Accepted: 10/15/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To conduct a comprehensive systematic meta-analysis investigating the association of nonsteroidal anti-inflammatory drugs (NSAIDs) and their subtypes with skin cancer (SC) and its subclasses (basal cell carcinoma BCC; squamous cell carcinoma SCC; melanoma; nonmelanoma skin cancer NMSC) in general, American and European populations. METHODS PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure and ClinicalTrials.gov were searched up to 24 February 2019. Pooled effect sizes and 95% confidence intervals were used to estimate associations. RESULTS Results based on 26 original studies including 223,619 cases and 1,398,507 controls showed both NSAIDs and nonselective Cyclooxygenase (COX) inhibitors to be statistically significantly associated with a reduced risk of SC, BCC, SCC and NMSC but not with melanoma. Conversely, no association was observed between selective Cyclooxygenase 2 (COX-2) inhibitors and SC or its subclasses. Further subgroup analysis showed that the results analyzed for American populations were almost the same as those for the general population. For European populations, neither NSAIDs nor its subtypes correlated significantly with susceptibility to SC or its subclasses. CONCLUSIONS The use of NSAIDs might reduce the risk of SC, but many factors including study population, drug subtype, and disease subclass affect the significance of the association.
Collapse
Affiliation(s)
- Yukun Ma
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Piaojian Yu
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Shuhuang Lin
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Qiqun Li
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Zijing Fang
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; The Second School of Clinical Medicine, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Zunnan Huang
- Key Laboratory of Big Data Mining and Precision Drug Design of Guangdong Medical University, Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, Guangdong Medical University, Dongguan, Guangdong 523808, China; Institute of Marine Biomedical Research, Guangdong Medical University, Zhanjiang, Guangdong 524023, China.
| |
Collapse
|
6
|
Kaiser U, Loeffler KU, Nadal J, Holz FG, Herwig-Carl MC. Polarization and Distribution of Tumor-Associated Macrophages and COX-2 Expression in Basal Cell Carcinoma of the Ocular Adnexae. Curr Eye Res 2018; 43:1126-1135. [PMID: 29775390 DOI: 10.1080/02713683.2018.1478980] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE Basal cell carcinoma (BCC) is a locally invasive skin tumor which can be subdivided into a circumscribed nodular and an invasive fibrosing subtype. There is increasing evidence that macrophages play an important role in interacting between tumor cells and their microenvironment, thereby affecting not only the invasive potential but also the patients' prognosis. Thus, we wanted to compare these two BCC variants with regard to tumor-related inflammation, COX-2 expression, distribution, and polarization of tumor-associated macrophages. MATERIAL AND METHODS 30 BCCs (nodular: n = 15; fibrosing: n = 15) of the ocular adnexae were investigated by histopathology and immunohistochemistry. The grade of inflammation was evaluated on hematoxylin and eosin stains (score: 0-3). Immunohistochemical stains for CD68 (macrophages), Ki67 (proliferative activity), and COX-2 as well as immunofluorescence stains for CD68 and CD163 (to distinguish M1 and M2 macrophage subtypes) were performed. SPSS was used for statistical analysis. RESULTS Fibrosing BCCs were predominantly located on the lower lid, while nodular BCCs showed a broader distribution (p = 0.013). The fibrosing BCC subtype was associated with a higher degree of inflammation (p < 0.001) and revealed a higher COX-2 immunoreactivity than nodular BCC (p = 0.012). COX-2-positive cells were predominantly located on the infiltrating edge of the tumor. Macrophage polarization was balanced regarding M1 and M2 macrophage subtypes. There was no difference in macrophage number (p = 0.389) or polarization (p = 0.161) between nodular and fibrosing BCC. CONCLUSIONS The findings indicate that COX-2 represents a factor for invasion of BCC. Macrophage polarization did not play a major role for aggressive behavior. However, other inflammatory components than tumor-associated macrophages seem to be involved in tissue destruction and thereby an invading growth pattern since fibrosing BCC revealed a significantly more intense inflammatory reaction in the surrounding tissue.
Collapse
Affiliation(s)
- Ute Kaiser
- a Department of Ophthalmology , University of Bonn , Bonn , Germany
| | - Karin U Loeffler
- a Department of Ophthalmology , University of Bonn , Bonn , Germany
| | - Jennifer Nadal
- b Institute of Medical Biometry, Informatics and Epidemiology , University of Bonn , Bonn , Germany
| | - Frank G Holz
- a Department of Ophthalmology , University of Bonn , Bonn , Germany
| | | |
Collapse
|
7
|
Qiao Y, Yang T, Gan Y, Li W, Wang C, Gong Y, Lu Z. Associations between aspirin use and the risk of cancers: a meta-analysis of observational studies. BMC Cancer 2018. [PMID: 29534696 PMCID: PMC5851082 DOI: 10.1186/s12885-018-4156-5] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Epidemiological studies have clarified the potential associations between regular aspirin use and cancers. However, it remains controversial on whether aspirin use decreases the risk of cancers risks. Therefore, we conducted an updated meta-analysis to assess the associations between aspirin use and cancers. Methods The PubMed, Embase, and Web of Science databases were systematically searched up to March 2017 to identify relevant studies. Relative risks (RRs) with 95% confidence intervals (CIs) were used to assess the strength of associations. Results A total of 218 studies with 309 reports were eligible for this meta-analysis. Aspirin use was associated with a significant decrease in the risk of overall cancer (RR = 0.89, 95% CI: 0.87–0.91), and gastric (RR = 0.75, 95% CI: 0.65–0.86), esophageal (RR = 0.75, 95% CI: 0.62–0.89), colorectal (RR = 0.79, 95% CI: 0.74–0.85), pancreatic (RR = 0.80, 95% CI: 0.68–0.93), ovarian (RR = 0.89, 95% CI: 0.83–0.95), endometrial (RR = 0.92, 95% CI: 0.85–0.99), breast (RR = 0.92, 95% CI: 0.88–0.96), and prostate (RR = 0.94, 95% CI: 0.90–0.99) cancers, as well as small intestine neuroendocrine tumors (RR = 0.17, 95% CI: 0.05–0.58). Conclusions These findings suggest that aspirin use is associated with a reduced risk of gastric, esophageal, colorectal, pancreatic, ovarian, endometrial, breast, and prostate cancers, and small intestine neuroendocrine tumors. Electronic supplementary material The online version of this article (10.1186/s12885-018-4156-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yan Qiao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Tingting Yang
- Department of Nutriology, The People's Hospital of Henan Province, Zhengzhou, Henan, 450003, People's Republic of China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
| |
Collapse
|
8
|
Muranushi C, Olsen CM, Green AC, Pandeya N. Can oral nonsteroidal antiinflammatory drugs play a role in the prevention of basal cell carcinoma? A systematic review and metaanalysis. J Am Acad Dermatol 2016; 74:108-119.e1. [DOI: 10.1016/j.jaad.2015.08.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 07/28/2015] [Accepted: 08/15/2015] [Indexed: 12/12/2022]
|
9
|
Lee T, Sigurdson AJ, Preston DL, Cahoon EK, Freedman DM, Simon SL, Nelson K, Matanoski G, Kitahara CM, Liu JJ, Wang T, Alexander BH, Doody MM, Linet MS, Little MP. Occupational ionising radiation and risk of basal cell carcinoma in US radiologic technologists (1983-2005). Occup Environ Med 2015; 72:862-9. [PMID: 26350677 PMCID: PMC10641595 DOI: 10.1136/oemed-2015-102880] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 08/17/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine risk for incident basal cell carcinoma from cumulative low-dose ionising radiation in the US radiologic technologist cohort. METHODS We analysed 65,719 Caucasian technologists who were cancer-free at baseline (1983-1989 or 1994-1998) and answered a follow-up questionnaire (2003-2005). Absorbed radiation dose to the skin in mGy for estimated cumulative occupational radiation exposure was reconstructed for each technologist based on badge dose measurements, questionnaire-derived work history and protection practices, and literature information. Radiation-associated risk was assessed using Poisson regression and included adjustment for several demographic, lifestyle, host and sun exposure factors. RESULTS Cumulative mean absorbed skin dose (to head/neck/arms) was 55.8 mGy (range 0-1735 mGy). For lifetime cumulative dose, we did not observe an excess radiation-related risk (excess relative risk/Gy=-0.01 (95% CI -0.43 to 0.52). However, we observed that basal cell carcinoma risk was increased for radiation dose received before age 30 (excess relative risk/Gy=0.59, 95% CI -0.11 to 1.42) and before 1960 (excess relative risk/Gy=2.92, 95% CI 1.39 to 4.45). CONCLUSIONS Basal cell carcinoma risk was unrelated to low-dose radiation exposure among radiologic technologists. Because of uncertainties in dosimetry and sensitivity to model specifications, both our null results and our findings of excess risk for dose received before age 30 and exposure before 1960 should be interpreted with caution.
Collapse
Affiliation(s)
- Terrence Lee
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Alice J. Sigurdson
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | | | - Elizabeth K. Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - D. Michal Freedman
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Kenrad Nelson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Genevieve Matanoski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Jason J. Liu
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Timothy Wang
- Department of Dermatology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Michele M. Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Mark P. Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| |
Collapse
|
10
|
Cahoon EK, Kitahara CM, Ntowe E, Bowen EM, Doody MM, Alexander BH, Lee T, Little MP, Linet MS, Freedman DM. Female Estrogen-Related Factors and Incidence of Basal Cell Carcinoma in a Nationwide US Cohort. J Clin Oncol 2015; 33:4058-65. [PMID: 26527779 PMCID: PMC4669591 DOI: 10.1200/jco.2015.62.0625] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose UV radiation exposure is the primary risk factor for basal cell carcinoma (BCC), the most common human malignancy. Although the photosensitizing properties of estrogens have been recognized for decades, few studies have examined the relationship between reproductive factors or exogenous estrogen use and BCC. Methods Using data from the US Radiologic Technologists Study, a large, nationwide, prospective cohort, we assessed the relationship between reproductive factors, exogenous estrogen use, and first primary BCC while accounting for sun exposure, personal sun sensitivity, and lifestyle factors for geographically dispersed women exposed to a wide range of ambient UV radiation. Results Elevated risk of BCC was associated with late age at natural menopause (hazard ratio [HR] for ≥ 55 years v 50 to 54 years, 1.50; 95% CI, 1.04 to 2.17) and any use of menopausal hormone therapy (MHT; HR, 1.16; 95% CI, 1.03 to 1.30; P for trend for duration = .001). BCC risk was most increased among women reporting natural menopause who used MHT for 10 or more years versus women who never used MHT (HR, 1.97; 95% CI, 1.35 to 2.87). Risk of BCC was not associated with age at menarche, parity, age at first birth, infertility, use of diethylstilbestrol by participant's mother, age at hysterectomy, or use of oral contraceptives. Conclusion These analyses confirm a previous finding of increased risk of BCC associated with MHT. Novel findings of increased BCC risk associated with MHT in women experiencing natural menopause and for late age at natural menopause warrant further investigation. Users of MHT may constitute an additional high-risk group in need of more frequent skin cancer screening.
Collapse
Affiliation(s)
- Elizabeth K Cahoon
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN.
| | - Cari M Kitahara
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Estelle Ntowe
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Emily M Bowen
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Michele M Doody
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Bruce H Alexander
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Terrence Lee
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Mark P Little
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Martha S Linet
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - D Michal Freedman
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| |
Collapse
|
11
|
ZHU YUN, CHENG YANG, LUO RONGCHENG, LI AIMIN. Aspirin for the primary prevention of skin cancer: A meta-analysis. Oncol Lett 2015; 9:1073-1080. [PMID: 25663859 PMCID: PMC4314970 DOI: 10.3892/ol.2015.2853] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 12/08/2014] [Indexed: 01/17/2023] Open
Abstract
Skin cancer is one of the most common cancers worldwide. There are three major skin cancer types: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. General risk factors for skin cancer include fair skin, a history of tanning and sunburn, family history of skin cancer, exposure to ultraviolet rays and a large number of moles. The incidence of skin cancer has increased in the USA in recent years. Aspirin intake is associated with chemoprotection against the development of a number of types of cancer. However, whether aspirin intake can reduce the risk of development of skin cancer is unclear. The present meta-analysis of available human studies is aimed at evaluating the association between aspirin exposure and the risk of skin cancer. All available human observational studies on aspirin intake for the primary prevention of skin cancer were identified by searching MEDLINE (Pubmed), BIOSIS, EMBASE, Cochrane Library and China National Knowledge Infrastructure prior to March 2013. The heterogeneity and publication bias of all studies were evaluated using Cochran's Q and I2 statistics, followed by a random-effect model where applicable. The pooled data were analyzed by odds ratios (ORs) and 95% confidence intervals (CIs). A total of eight case-control and five prospective cohort studies from 11 publications were selected for this analysis. There was no evidence of publication bias in these studies. Statistical analyses of the pooled data demonstrated that that a daily dose of 50-400 mg aspirin was significantly associated with a reduced risk of skin cancers (OR, 0.94; 95% CI, 0.90-0.99; P=0.02). Stratification analysis indicated that the continual intake of low dose aspirin (≤150 mg) reduced the risk of developing skin cancer (OR, 0.95; CI, 0.90-0.99; P=0.15) and that aspirin intake was significantly associated with a reduced risk of non-melanoma skin cancers (OR, 0.97; CI, 0.95-0.99; P=0.22). Overall, these findings indicated that aspirin intake was associated with a reduced risk of developing skin cancer. However, more well-designed randomized controlled trials to measure the effects of aspirin intake are required to confirm this.
Collapse
Affiliation(s)
- YUN ZHU
- Cancer Center, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - YANG CHENG
- Digestive Department of Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - RONG-CHENG LUO
- Cancer Center, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
- Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, Guangdong 510315, P.R. China
- Correspondence to: Dr Rong-Cheng Luo and Dr Ai-Min Li, Cancer Center, Southern Medical University, 1838 North Guangzhou Road, Guangzhou, Guangdong 510515, P.R. China, E-mail: , E-mail:
| | - AI-MIN LI
- Cancer Center, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
- Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, Guangdong 510315, P.R. China
- Correspondence to: Dr Rong-Cheng Luo and Dr Ai-Min Li, Cancer Center, Southern Medical University, 1838 North Guangzhou Road, Guangzhou, Guangdong 510515, P.R. China, E-mail: , E-mail:
| |
Collapse
|
12
|
Zhang B, Liang X, Ye L, Wang Y. No chemopreventive effect of nonsteroidal anti-inflammatory drugs on nonmelanoma skin cancer: evidence from meta-analysis. PLoS One 2014; 9:e96887. [PMID: 24828489 PMCID: PMC4020781 DOI: 10.1371/journal.pone.0096887] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 04/12/2014] [Indexed: 12/17/2022] Open
Abstract
Background Nonmelanoma skin cancer (NMSC),which includes squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), is the most common form of cancer, and its incidence is increasing. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to be chemopreventive for NMSC. However, the results from published studies were controversial. Methods We searched the PubMed and Embase databases for relevant studies. Moreover, relevant reviews regarding the use of NSAIDs for NMSC patients were examined for potential inclusive studies. To measure the effects of NSAIDs, the relative risk (RR) was analyzed. Results A Total of 8 studies were included in our meta-analysis. We found that NSAIDs use was not associated with a reduced risk of SCC or BCC under the random effects model (pooled RR = 0.86, 95% CI, 0.73–1.02, P = 0.085; pooled RR = 0.94, 95% CI 0.85–1.04, P = 0.266; respectively). Conclusion From the included studies, we found no statistically significant chemopreventive effect on NMSC of NSAIDs. This finding warrants more prospective studies evaluating the relationship between NSAIDs and NMSC.
Collapse
Affiliation(s)
- Bo Zhang
- Training Division, Third Military Medical Universality, Chongqing, China
- Department of medical administration, General Hospital of Beijing Military Command, Beijing, China
- * E-mail: (YW); (BZ)
| | - Xiaolu Liang
- Department of Ultrasonography, General Hospital of Beijing Military Command, Beijing, China
| | - Liaosha Ye
- Department of medical administration, General Hospital of Beijing Military Command, Beijing, China
| | - Yungui Wang
- Training Division, Third Military Medical Universality, Chongqing, China
- * E-mail: (YW); (BZ)
| |
Collapse
|
13
|
McDonald E, Freedman DM, Alexander BH, Doody MM, Tucker MA, Linet MS, Cahoon EK. Prescription diuretic use and risk of basal cell carcinoma in the nationwide U.S. radiologic technologists cohort. Cancer Epidemiol Biomarkers Prev 2014; 23:1539-45. [PMID: 24812037 DOI: 10.1158/1055-9965.epi-14-0251] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND UV radiation (UVR) exposure is the primary risk factor for basal cell carcinoma (BCC). Although prescription diuretics have photosensitizing properties, the relationship between diuretic use and BCC remains unclear. METHODS Using data from the United States Radiologic Technologists Study, a large, nationwide prospective cohort, we assessed the relationship between diuretic use and first primary BCC while accounting for sun exposure history, constitutional characteristics, lifestyle factors, and anthropometric measurements for geographically dispersed individuals exposed to a wide range of ambient UVR. RESULTS After adjustment for potential confounders, we found a significantly increased risk of BCC associated with diuretic use [HR, 1.22; 95% confidence interval (CI), 1.07-1.38]. This relationship was modified by body mass index (P = 0.019), such that BCC risk was increased with diuretic use in overweight (HR, 1.43; 95% CI, 1.16-1.76) and obese individuals (HR, 1.43; 95% CI, 1.09-1.88), but not in normal weight individuals (HR, 0.99; 95% CI, 0.81-1.21). CONCLUSIONS Increased risk of BCC associated with diuretic use in overweight and obese participants may be related to higher dosages, longer duration of medication use, reduced drug metabolism, or drug interactions. IMPACT Future cohort studies should obtain more detailed information on medication use, consider factors that affect drug metabolism, and measure intermediate endpoints such as photosensitivity reactions.
Collapse
Affiliation(s)
- Emily McDonald
- Department of Epidemiology and Biostatistics, Indiana University, School of Public Health, Bloomington, Indiana; Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and
| | - D Michal Freedman
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota, School of Public Health, Minneapolis, Minnesota
| | - Michele M Doody
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and
| | - Margaret A Tucker
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and
| | - Elizabeth K Cahoon
- Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and
| |
Collapse
|
14
|
Priming effect of aspirin for tumor cells to augment cytotoxic action of cisplatin against tumor cells: implication of altered constitution of tumor microenvironment, expression of cell cycle, apoptosis, and survival regulatory molecules. Mol Cell Biochem 2012; 371:43-54. [DOI: 10.1007/s11010-012-1421-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 08/01/2012] [Indexed: 10/28/2022]
|