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Chen X, Song S, Shi J, Wang Z, Song W, Wang J, Wang G, Wang X. Evaluating the effect of body mass index and 25-hydroxy-vitamin D level on basal cell carcinoma using Mendelian randomization. Sci Rep 2023; 13:16552. [PMID: 37783777 PMCID: PMC10545741 DOI: 10.1038/s41598-023-43926-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 09/30/2023] [Indexed: 10/04/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common cancer with a rising incidence among white-skinned individuals. A number of epidemiological studies have suggested that obesity and serum 25-hydroxy-vitamin D (25(OH)D) levels may affect the arising of BCC. To address this, we selected 443 and 96 single nucleotide polymorphisms (SNPs) associated with body mass index (BMI) and serum level of 25(OH)D from large-scale genome-wide association studies (GWAS), respectively. The univariable and multivariable two-sample Mendelian randomization (MR) analyses were conducted with a series of sensitivity analyses to ensure the results were reliable and reproducible. The results of univariable two-sample MR analysis showed that higher BMI was related to lower risk for BCC (Odds ratio(OR) = 0.90; 95% confidence interval (CI),[0.81,0.99]; p = 0.02). In addition, this causal effect of BMI on BCC still remained (OR = 0.88; 95%CI,[- 0.22, - 0.03], p-value = 0.008) after adjusting for 25(OH)D level in the multivariable MR analysis. However, the results suggested that 25(OH)D level was not associated with BCC(OR = 1.02; 95%CI, [0.94,1.09], p-value = 0.67). In conclusion, similar to the conclusions of retrospective observational studies, the MR results indicate that high BMI is an independent protective factor for BCC. Meanwhile, vitamin D levels may not be causally associated with the risk of basal cell carcinoma and increasing vitamin D supplementation is unlikely to reduce the risk.
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Affiliation(s)
- Xuezhao Chen
- Shanxi Medical University, Taiyuan, China
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - Shan Song
- Shanxi Medical University, Taiyuan, China
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jinyu Shi
- Shanxi Medical University, Taiyuan, China
- Department of Breast Surgery, The Fifth Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhiyao Wang
- Department of Clinical Medical College, Shanxi Datong University, Datong, China
| | - Wenyu Song
- Shanxi Medical University, Taiyuan, China
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - Jiaxin Wang
- Shanxi Medical University, Taiyuan, China
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - Guoyan Wang
- Shanxi Medical University, Taiyuan, China
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - Xiaobing Wang
- Department of Plastic Surgery, The First Hospital of Shanxi Medical University, Taiyuan, 030000, Shanxi, China.
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2
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Safi S, Ahmadzade M, Karimi S, Akbari ME, Rouientan H, Abolhosseini M, Rezaei Kanavi M, Khorrami Z. A registration trend in eyelid skin cancers and associated risk factors in Iran, 2005-2016. BMC Cancer 2023; 23:924. [PMID: 37777736 PMCID: PMC10543867 DOI: 10.1186/s12885-023-11414-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/17/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Eyelid skin cancers are the most prevalent ophthalmic malignancies. This study aimed to evaluate the association of the Human Development Index (HDI) and lifestyle risk factors with eyelid skin cancers in Iran. METHODS This ecological study analyzed the data collected from the Iranian National Population-based Cancer Registry (2005-2016). The data on provincial-level eyelid skin cancer risk factors were obtained from national sources. The association between provincial HDI and lifestyle risk factors with the prevalence of eyelid skin cancers was assessed. RESULTS The mean 12-year age-standardized incidence rate (ASIR) of eyelid skin cancers was 16.22 per 100,000 (9,104 cases). The overall ASIR showed an upward trend with an estimated annual average increase of 0.006 per year. There were positive correlations between the prevalence of overall eyelid skin cancers and provincial HDI, smoking, and obesity (r = 0.32, 0.42, and 0.37, respectively). In multivariate analysis, obesity/overweight remained a positive predictor for high prevalence of total eyelid skin cancers (OR = 1.97, 95%CI = 1.08-3.58, P = 0.026), carcinoma (2.10, 1.15-3.83, P = 0.015), and basal cell carcinoma (1.48, 0.99-2.20, P = 0.054). CONCLUSIONS An increasing trend in ASIR of eyelid skin cancers was observed in more than a decade in Iran which was positively associated with provincial HDI and prevalence of obesity. The findings of the study highlight the importance of promotional programs for preventing obesity/overweight and appropriate allocation of screening facilities based on the HDI level.
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Affiliation(s)
- Sare Safi
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohadese Ahmadzade
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Karimi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Rouientan
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Abolhosseini
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mozhgan Rezaei Kanavi
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zahra Khorrami
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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3
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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.
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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
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Lu L, Wan B, Zeng H, Guo J, Li M, Sun M. Body mass index and the risk of basal cell carcinoma: evidence from Mendelian randomization analysis. PeerJ 2023; 11:e14781. [PMID: 36710862 PMCID: PMC9881466 DOI: 10.7717/peerj.14781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023] Open
Abstract
Objective We aim to test whether body mass index (BMI) is causally associated with the risk of basal cell carcinoma (BCC) using Mendelian randomization (MR) analysis. Methods Single-nucleotide polymorphisms (SNPs) associated with four BMI-related traits were screened via a genome-wide association study (GWAS) with 681,275, 336,107, 454,884, and 461,460 European-descent individuals, respectively. Summary-level data for BCC (17,416 cases and 375,455 controls) were extracted from UK Biobank. An inverse variance weighted (IVW) method was employed as the primary MR analysis. Sensitivity analyses were conducted via MR-Egger regression, heterogeneity test, pleiotropy test, and leave-one-out sensitivity test. The assumption that exposure causes outcome was verified using the MR Steiger test. Meta-analysis was also used to estimate the average genetically predicted effect of BMI on BCC. Results Two-sample MR analysis showed inverse associations between genetically predicted BMI and BCC risk. Moreover, when exposure and outcome were switched to see if reverse causation was possible, there was no evidence of a cause-and-effect relationship from BCC to BMI. Finally, the meta-analysis also showed a strong negative causal relationship between BMI and BCC. Conclusion Genetical predicted higher BMI were associated with lower BCC risk. Further research is required to comprehend the mechanisms underlying this putative causative association.
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Affiliation(s)
- Likui Lu
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Bangbei Wan
- Reproductive Medical Center, Hainan Women and Children’s Medical Center, Haikou, Hainan, China
- Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, Hainan, China
| | - Hongtao Zeng
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jun Guo
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Min Li
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Dermatology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu Province, China
| | - Miao Sun
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu Province, China
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5
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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.
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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
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Adolphe C, Xue A, Fard AT, Genovesi LA, Yang J, Wainwright BJ. Genetic and functional interaction network analysis reveals global enrichment of regulatory T cell genes influencing basal cell carcinoma susceptibility. Genome Med 2021; 13:19. [PMID: 33549134 PMCID: PMC7866769 DOI: 10.1186/s13073-021-00827-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/07/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Basal cell carcinoma (BCC) of the skin is the most common form of human cancer, with more than 90% of tumours presenting with clear genetic activation of the Hedgehog pathway. However, polygenic risk factors affecting mechanisms such as DNA repair and cell cycle checkpoints or which modulate the tumour microenvironment or host immune system play significant roles in determining whether genetic mutations culminate in BCC development. We set out to define background genetic factors that play a role in influencing BCC susceptibility via promoting or suppressing the effects of oncogenic drivers of BCC. METHODS We performed genome-wide association studies (GWAS) on 17,416 cases and 375,455 controls. We subsequently performed statistical analysis by integrating data from population-based genetic studies of multi-omics data, including blood- and skin-specific expression quantitative trait loci and methylation quantitative trait loci, thereby defining a list of functionally relevant candidate BCC susceptibility genes from our GWAS loci. We also constructed a local GWAS functional interaction network (consisting of GWAS nearest genes) and another functional interaction network, consisting specifically of candidate BCC susceptibility genes. RESULTS A total of 71 GWAS loci and 46 functional candidate BCC susceptibility genes were identified. Increased risk of BCC was associated with the decreased expression of 26 susceptibility genes and increased expression of 20 susceptibility genes. Pathway analysis of the functional candidate gene regulatory network revealed strong enrichment for cell cycle, cell death, and immune regulation processes, with a global enrichment of genes and proteins linked to TReg cell biology. CONCLUSIONS Our genome-wide association analyses and functional interaction network analysis reveal an enrichment of risk variants that function in an immunosuppressive regulatory network, likely hindering cancer immune surveillance and effective antitumour immunity.
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Affiliation(s)
- Christelle Adolphe
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
- The University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, 4102, Australia
| | - Angli Xue
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Atefeh Taherian Fard
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Laura A Genovesi
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia
- The University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, 4102, Australia
| | - Jian Yang
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia.
- School of Life Sciences, Westlake University, Hangzhou, 310024, Zhejiang, China.
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, 310024, Zhejiang, China.
| | - Brandon J Wainwright
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, 4072, Australia.
- The University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, 4102, Australia.
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7
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Abstract
We trained and validated risk prediction models for the three major types of skin cancer- basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma-on a cross-sectional and longitudinal dataset of 210,000 consented research participants who responded to an online survey covering personal and family history of skin cancer, skin susceptibility, and UV exposure. We developed a primary disease risk score (DRS) that combined all 32 identified genetic and non-genetic risk factors. Top percentile DRS was associated with an up to 13-fold increase (odds ratio per standard deviation increase >2.5) in the risk of developing skin cancer relative to the middle DRS percentile. To derive lifetime risk trajectories for the three skin cancers, we developed a second and age independent disease score, called DRSA. Using incident cases, we demonstrated that DRSA could be used in early detection programs for identifying high risk asymptotic individuals, and predicting when they are likely to develop skin cancer. High DRSA scores were not only associated with earlier disease diagnosis (by up to 14 years), but also with more severe and recurrent forms of skin cancer.
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8
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Do Diet and Lifestyles Play a Role in the Pathogenesis of NMSCs? Nutrients 2020; 12:nu12113459. [PMID: 33187245 PMCID: PMC7697298 DOI: 10.3390/nu12113459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022] Open
Abstract
Background and Aims: Literature highlights the role of risk factors like age, body mass index (BMI), tobacco smoking, alcohol intake and diet in the pathogenesis of several cancer types but little is known for non-melanoma skin cancers (NMSC). The aim of this epidemiological study was to evaluate the correlation between modifiable risk factors (BMI, metabolic panel, diet, lifestyle, medical history) and not modifiable risk factors (gender, age) and NMSC development. Methods: From February 2018 to September 2019, 162 patients affected by NMSC were compared to a group of 167 controls. A univariate and multivariate analysis was conducted to elaborate the data collected through face-to-face interviews. Results: While our evidence did not always reach statistical significance, NMSC study group patients exhibited high rates of analyzed risk factors (male gender aging over 55 years, high BMI, reduced physical activity) compared to the control group. Conclusions: Our study indicates that practicing more than 30 min of physical activity daily could be a protective factor against the NMSC onset. Other risk factors were not correlated with NMSC, but more evidence is needed to establish a possible link.
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Bchetnia M, Allard JP, Boucher-Lafleur AM, Cruz Marino T, Dupéré A, Powell J, McCuaig C, Bernier MÈ, Laprise C. Severe epidermolysis bullosa simplex phenotype caused by codominant mutations p.Ile377Thr in keratin 14 and p.Gly138Glu in keratin 5. Exp Dermatol 2020; 29:961-969. [PMID: 32885477 DOI: 10.1111/exd.14189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/28/2020] [Accepted: 08/24/2020] [Indexed: 12/22/2022]
Abstract
Epidermolysis bullosa simplex (EBS) is a rare skin disease usually inherited in an autosomal dominant pattern. EBS is resulting from mutations in keratin 5 (KRT5) and keratin 14 (KRT14) genes encoding the keratins 5 and 14 proteins expressed in the keratinocytes of the basal layer of the epidermis. To date, seven pathogenic mutations have been reported to be responsible for EBS in the Canadian population from the province of Quebec: p.Pro25Leu, p.Leu150Pro, p.Met327Thr and p.Arg559X in KRT5; p.Arg125Ser, p.Ile377Thr and p.Ile412Phe in KRT14. Here, we present a novel French-Canadian patient diagnosed with EBS confined to the soles but presenting a severe complication form including blisters, hyperkeratosis, skin erosions and toenail abnormalities. Mutation screening was performed by direct sequencing of the entire coding regions of KRT5 and KRT14 genes and revealed the previously reported missense heterozygous mutation c. 1130T > C in KRT14 (p.Ile377Thr). Furthermore, this patient is carrying a second mutation in KRT5, c.413G > A (p.Gly138Glu), which has been linked to an increased risk of basal cell carcinoma in the literature. We suspect an impact of the p.Gly138Glu variant on the EBS phenotype severity of the studied patient. The pathogenicity and consequences of both genetic variations were simulated by in silico tools.
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Affiliation(s)
- Mbarka Bchetnia
- Centre intersectoriel en santé durable, Département des sciences fondamentales, Université du Québec à Chicoutimi (UQAC), Saguenay, QC, Canada
| | - Jean-Pascal Allard
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada
| | - Anne-Marie Boucher-Lafleur
- Centre intersectoriel en santé durable, Département des sciences fondamentales, Université du Québec à Chicoutimi (UQAC), Saguenay, QC, Canada
| | - Tania Cruz Marino
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada
| | - Audrey Dupéré
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada
| | - Julie Powell
- Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada
| | - Catherine McCuaig
- Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, QC, Canada
| | - Marie-Ève Bernier
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada
| | - Catherine Laprise
- Centre intersectoriel en santé durable, Département des sciences fondamentales, Université du Québec à Chicoutimi (UQAC), Saguenay, QC, Canada.,Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada
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10
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Si S, Tewara MA, Ji X, Wang Y, Liu Y, Dai X, Wang Z, Xue F. Body surface area, height, and body fat percentage as more sensitive risk factors of cancer and cardiovascular disease. Cancer Med 2020; 9:4433-4446. [PMID: 32342643 PMCID: PMC7300397 DOI: 10.1002/cam4.3076] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Limited studies have compared the association between various physical measurements and the risk of cancer or cardiovascular disease (CVD). We aim to explore the best-individualized indicators of cancer and CVD risk assessment. METHODS From May 2004 to December 2017, a community-based cohort in China involving 100 280 participants were enrolled. BMI, height, body surface area (BSA), and body fat percentage (BFP) were compared in parallel about cancer and CVD risk with the multivariable-adjusted Cox proportional hazard regression model. RESULTS Within the follow-up period, 3107 (3.10%) were diagnosed with cancer and 3721 (3.71%) had CVD. Per-level increased (in tertile: T1, T2, and T3 level) BSA, height, and BFP was positively associated with the risk of overall cancer [HR (95% CI): 1.10 (1.05-1.15), 1.12 (1.07-1.18), and 1.10 (1.03-1.16), respectively], whereas BMI was insignificant. Compared with the reference group (T2), the highest BSA level (T3) was positively associated with overall cancer incidence for both male [HR (95% CI): 1.28 (1.13-1.45)] and female [HR (95% CI): 1.13 (1.00-1.28)]. The BSA, height, and BFP also significantly associated with some site-specific cancers including thyroid, stomach, breast, urinary system, and skin cancer. Meanwhile, BFP presented a strong positive association with overall CVD [HR (95% CI): 1.22 (1.15-1.30) in trend] in both gender and associated with nearly all CVD subtypes especially the myocardial infarction and heart failure. CONCLUSION BSA, height, and BFP have more sensitivity in assessing cancer risk and BFP shows the largest hazard ratios for CVD incident. We provided valuable evidence for the application of height, BSA, and BFP in routine healthcare practice. These encouraging findings should be tested in more well-defined studies for risk prediction.
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Affiliation(s)
- Shucheng Si
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Marlvin A Tewara
- Institute for Medical Dataology, Shandong University, Jinan, P.R. China
| | - Xiaokang Ji
- Institute for Medical Dataology, Shandong University, Jinan, P.R. China
| | - Yongchao Wang
- Institute for Medical Dataology, Shandong University, Jinan, P.R. China
| | - Yanxun Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China.,Institute for Medical Dataology, Shandong University, Jinan, P.R. China
| | - Xiaoyu Dai
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Zhiheng Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China.,Institute for Medical Dataology, Shandong University, Jinan, P.R. China
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11
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Hirt PA, Castillo DE, Yosipovitch G, Keri JE. Skin changes in the obese patient. J Am Acad Dermatol 2019; 81:1037-1057. [DOI: 10.1016/j.jaad.2018.12.070] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 12/31/2022]
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12
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Chan AA, Noguti J, Pak Y, Qi L, Caan B, Going S, Han J, Chlebowski RT, Lee DJ. Interaction of body mass index or waist-to-hip ratio and sun exposure associated with nonmelanoma skin cancer: A prospective study from the Women's Health Initiative. Cancer 2018; 125:1133-1142. [PMID: 30548236 DOI: 10.1002/cncr.31810] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 09/19/2018] [Accepted: 09/24/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The incidence of nonmelanoma skin cancer (NMSC) exceeds the incidence of all other types of cancers combined. Cumulative sun exposure and intermittent sun exposure are known risk factors for the development of NMSC. Because obesity has been shown to decrease the risk of NMSC incidence, this study investigated whether the risk of NMSC with sun exposure was consistent across different levels of body size. METHODS Body size was assessed with the body mass index (BMI) and the waist-to-hip ratio (WHR). Sun exposure was assessed in watts and langleys and by the amount of time spent outdoors per day in the summer during a person's 30s. RESULTS Among 71,645 postmenopausal women eligible for inclusion in this study, 13,351 participants (18.6%) developed NMSC. A BMI ≥ 25 kg/m2 or a WHR ≥ 0.80 was associated with lower NMSC hazard rates (hazard ratio for BMI, 0.78; hazard ratio for WHR, 0.89); however, the association between higher levels of sun exposure and a higher risk of NMSC was more apparent among women with a BMI ≥ 25 kg/m2 or a WHR ≥ 0.80 in comparison with those of a normal weight (P for interaction for BMI < .001; P for interaction for WHR = .022). CONCLUSIONS Although most studies have considered sun exposure as a covariate, none have addressed the potential interaction of body size with sun exposure; therefore, the effect size of being overweight or obese may have been overestimated. In comparison to the normal-weight group, those in the overweight group had increasingly higher hazard rates with increasing sun exposure. Further studies are warranted to investigate how increased weight interacts with sun exposure to influence skin cancer pathogenesis.
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Affiliation(s)
- Alfred A Chan
- Division of Dermatology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Juliana Noguti
- Division of Dermatology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Youngju Pak
- Division of Dermatology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, Davis, California
| | - Bette Caan
- Early Stage Investigator Training Program, Division of Research, Kaiser Permanente, Oakland, California
| | - Scott Going
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Rowan T Chlebowski
- Division of Dermatology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Delphine J Lee
- Division of Dermatology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.,David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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Little MP, Tatalovich Z, Linet MS, Fang M, Kendall GM, Kimlin MG. Improving Assessment of Lifetime Solar Ultraviolet Radiation Exposure in Epidemiologic Studies: Comparison of Ultraviolet Exposure Assessment Methods in a Nationwide U.S. Occupational Cohort. Photochem Photobiol 2018; 94:1297-1307. [PMID: 29896764 DOI: 10.1111/php.12964] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/10/2018] [Indexed: 01/19/2023]
Abstract
Solar ultraviolet radiation is the primary risk factor for skin cancers and sun-related eye disorders. Estimates of individual ambient ultraviolet irradiance derived from ground-based solar measurements and from satellite measurements have rarely been compared. Using self-reported residential history from 67 189 persons in a nationwide occupational US radiologic technologists' cohort, we estimated ambient solar irradiance using data from ground-based meters and noontime satellite measurements. The mean distance moved from city of longest residence in childhood increased from 137.6 km at ages 13-19 to 870.3 km at ages ≥65, with corresponding increases in absolute latitude difference moved. At ages 20/40/60/80, the Pearson/Spearman correlation coefficients of ground-based and satellite-derived potential solar ultraviolet exposure, using irradiance and cumulative radiant exposure metrics, were high (=0.87-0.92). There was also moderate correlation (Pearson/Spearman correlation coefficients = 0.51-0.60) between irradiance at birth and at last-known address, for ground-based and satellite data. Satellite-based lifetime estimates of ultraviolet radiation were generally 14-15% lower than ground-based estimates, albeit with substantial uncertainties, possibly because ground-based estimates incorporate fluctuations in cloud and ozone, which are incompletely incorporated in the single noontime satellite-overpass ultraviolet value. If confirmed elsewhere, the findings suggest that ground-based estimates may improve exposure assessment accuracy and potentially provide new insights into ultraviolet radiation-disease relationships in epidemiologic studies.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Zaria Tatalovich
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Michelle Fang
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | | | - Michael G Kimlin
- NHMRC Centre for Research Excellence in Sun and Health, University of the Sunshine Coast, Maroochydore, Qld, Australia
- Cancer Council Queensland, Qld, Australia
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14
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Lee YB, Lee JH, Kang MJ, Kim JW, Yu DS, Han KD, Park YG. Association between Height and Actinic Keratosis: A Nationwide Population-based Study in South Korea. Sci Rep 2018; 8:10897. [PMID: 30022092 PMCID: PMC6052058 DOI: 10.1038/s41598-018-29155-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/06/2018] [Indexed: 11/12/2022] Open
Abstract
The association between actinic keratosis (AK) and anthropometric measures has not been investigated. This study aims to evaluate the associations between anthropometric measures and the incidence of AK in South Korea. We analyzed clinical data from individuals aged over 20 years who received a health examination arranged by the national insurance program between 2005 and 2008. Newly diagnosed AK was identified using claims data from baseline to the date of diagnosis or until December 31, 2015. The incidence of AK was highest among the elderly (aged over 60 years) and showed a male bias. The risk of AK increased with greater height. The quintile with the greatest height had an increased risk of AK compared with the quintile with the lowest height (hazard ratio = 1.28, 95% confidence interval: 1.24-1.33) after adjustment for age, sex, income, smoking status, alcohol consumption, hypertension, dyslipidemia, myocardial infarction, congestive heart failure, and chronic obstructive pulmonary disease. This study showed a positive association between the incidence of AK and human height. However, it is unclear whether these findings can be generalized to Koreans who have not received an examination or to populations in other countries.
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Affiliation(s)
- Young Bok Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Hyun Lee
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Min Ji Kang
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin-Wou Kim
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Soo Yu
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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15
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Abstract
Purpose of the review To provide a synopsis of recent research advances in the epidemiology of keratinocyte carcinoma (KC), with a focus on indoor tanning and known risk factors for other forms of cancer such as cigarette smoking and alcohol drinking. Recent findings The evidence is strong enough to infer that use of UVR-emitting indoor tanning devices cause KC. Epidemiologic studies of cigarette smoking, alcohol drinking, and menopausal hormone therapy all show some suggestion for increased risk of KC but the evidence is not yet strong enough to determine if there is a true etiologic role. Body mass index is clearly inversely associated with KC risk but this is more likely to be due to lower UVR exposure in overweight and obese individuals than it is due to a true etiologic role. Summary The epidemic of KC continues unabated, and the causal role of indoor tanning is contributing to this unfavorable trend in KC incidence rates. Advances in understanding the etiology of KC should not divert attention away from the fact that the primary public health strategy to prevent KC is known: minimize population exposure to UVR from the sun and from UVR-emitting indoor tanning devices, particularly among those with sun-sensitive phenotypes.
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A systematic SNP selection approach to identify mechanisms underlying disease aetiology: linking height to post-menopausal breast and colorectal cancer risk. Sci Rep 2017; 7:41034. [PMID: 28117334 PMCID: PMC5259777 DOI: 10.1038/srep41034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/15/2016] [Indexed: 01/28/2023] Open
Abstract
Data from GWAS suggest that SNPs associated with complex diseases or traits tend to co-segregate in regions of low recombination, harbouring functionally linked gene clusters. This phenomenon allows for selecting a limited number of SNPs from GWAS repositories for large-scale studies investigating shared mechanisms between diseases. For example, we were interested in shared mechanisms between adult-attained height and post-menopausal breast cancer (BC) and colorectal cancer (CRC) risk, because height is a risk factor for these cancers, though likely not a causal factor. Using SNPs from public GWAS repositories at p-values < 1 × 10−5 and a genomic sliding window of 1 mega base pair, we identified SNP clusters including at least one SNP associated with height and one SNP associated with either post-menopausal BC or CRC risk (or both). SNPs were annotated to genes using HapMap and GRAIL and analysed for significantly overrepresented pathways using ConsensuspathDB. Twelve clusters including 56 SNPs annotated to 26 genes were prioritised because these included at least one height- and one BC risk- or CRC risk-associated SNP annotated to the same gene. Annotated genes were involved in Indian hedgehog signalling (p-value = 7.78 × 10−7) and several cancer site-specific pathways. This systematic approach identified a limited number of clustered SNPs, which pinpoint potential shared mechanisms linking together the complex phenotypes height, post-menopausal BC and CRC.
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17
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Zhang Y, Cartmel B, Choy CC, Molinaro AM, Leffell DJ, Bale AE, Mayne ST, Ferrucci LM. Body mass index, height and early-onset basal cell carcinoma in a case-control study. Cancer Epidemiol 2016; 46:66-72. [PMID: 28039770 DOI: 10.1016/j.canep.2016.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/30/2016] [Accepted: 12/14/2016] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Basal cell carcinoma (BCC) is the most common malignancy in the US. Body mass index (BMI) and height have been associated with a variety of cancer types, yet the evidence regarding BCC is limited. Therefore, we evaluated BMI and height in relation to early-onset BCC (under age 40) and explored the potential role of ultraviolet (UV) radiation exposure and estrogen-related exposures in the BMI-BCC relationship. METHODS BCC cases (n=377) were identified through a central dermatopathology facility in Connecticut. Control subjects (n=389) with benign skin conditions were randomly sampled from the same database and frequency matched to cases on age (median=36, interquartile range 33-39), gender, and biopsy site. Participants reported weight (usual adult and at age 18), adult height, sociodemographic, phenotypic, and medical characteristics, and prior UV exposures. We calculated multivariate odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression models. RESULTS Adult BMI was inversely associated with early-onset BCC (obese vs. normal OR=0.43, 95% CI=0.26-0.71). A similar inverse association was present for BMI at age 18 (OR=0.54, 95% CI=0.34-0.85). Excluding UV exposures from the BMI models and including estrogen-related exposures among women only did not alter the association between BMI and BCC, indicating limited mediation or confounding. We did not observe an association between adult height and BCC (OR per cm=1.00, 95% CI=0.98-1.02). CONCLUSIONS We found a significant inverse association between BMI and early-onset BCC, but no association between height and BCC. This association was not explained by UV exposures or estrogen-related exposures in women.
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Affiliation(s)
- Yanchang Zhang
- Yale School of Public Health, New Haven, CT, 06520, United States
| | - Brenda Cartmel
- Yale School of Public Health, New Haven, CT, 06520, United States; Yale Cancer Center, New Haven, CT, 06520, United States
| | - Courtney C Choy
- Yale School of Public Health, New Haven, CT, 06520, United States
| | - Annette M Molinaro
- UCSF Departments of Neurological Surgery and Epidemiology and Biostatistics, San Francisco, CA 94143, United States
| | - David J Leffell
- Yale Cancer Center, New Haven, CT, 06520, United States; Yale University School of Medicine, New Haven, CT 06520, United States
| | - Allen E Bale
- Yale Cancer Center, New Haven, CT, 06520, United States; Yale University School of Medicine, New Haven, CT 06520, United States
| | - Susan T Mayne
- Yale School of Public Health, New Haven, CT, 06520, United States; Yale Cancer Center, New Haven, CT, 06520, United States
| | - Leah M Ferrucci
- Yale School of Public Health, New Haven, CT, 06520, United States; Yale Cancer Center, New Haven, CT, 06520, United States.
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18
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Body mass index and risk of non-melanoma skin cancer: cumulative evidence from prospective studies. Sci Rep 2016; 6:37691. [PMID: 27898109 PMCID: PMC5127294 DOI: 10.1038/srep37691] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/03/2016] [Indexed: 11/08/2022] Open
Abstract
Prospective epidemiologic studies that investigated the association between body mass index (BMI) and non-melanoma skin cancer (NMSC) yielded inconsistent findings. A dose-response meta-analysis was conducted to quantitatively summarize the evidence. PubMed and Embase databases were searched for relevant studies. Study-specific relative risk (RR) and 95% confidence interval (CI) for an increase in BMI of 5 kg/m2 was computed with the generalized least squares trend estimation, and these risk estimates were combined with the random-effects model. Nine publications were included in the final analyses, consisting of 18 independent cohorts with 22 risk estimates (971,795 participants and 50,561 NMSC cases). Results of the dose-response analyses showed a nonlinear inverse relationship between BMI and NMSC (RR = 0.88, 95% CI: 0.85–0.91, I2 = 71.2%, P-nonlinearity <0.001), which persisted when limiting to the studies with adjustment for important potential confounders including sun exposure and sensitivity factors. The risk estimates were very similar for squamous cell carcinoma and basal cell carcinoma. Sex appeared a source of heterogeneity (P-difference = 0.06), with a weaker, but still significant inverse association in men than in women. This dose-response meta-analysis suggests a nonlinear inverse association between BMI and NMSC.
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Lahmann PH, Hughes MCB, Williams GM, Green AC. A prospective study of measured body size and height and risk of keratinocyte cancers and melanoma. Cancer Epidemiol 2015; 40:119-25. [PMID: 26707237 DOI: 10.1016/j.canep.2015.12.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/05/2015] [Accepted: 12/10/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The potential influence of measured body weight and height on keratinocyte skin cancer risk has scarcely been studied. Some evidence indicates melanoma risk increases as self-reported height increases, but an association with body mass index (BMI) is less certain. METHODS We measured body weight and height of 1171 Australian men and women in a community-based skin cancer study in Queensland and prospectively examined the association of BMI, body surface area (BSA) and height and incidence of basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma while accounting for skin phenotype, sun exposure, clinical/cutaneous signs of chronic photodamage and other risk factors. RESULTS During 16 years of follow-up, 334 and 188 participants newly developed BCC and SCC, respectively; 28 participants were diagnosed with primary melanoma. BMI and BSA were unrelated to skin cancer incidence. After full adjustment, height was significantly associated with SCC development in men (relative risk (RR)=1.66; 95% confidence interval (CI)=1.11-2.48, for ≥175cm vs ≤171cm, Ptrend=0.017), and BCC in women (Ptrend=0.043). Melanoma in men, was similarly positively associated with height (RR per 5cm increment=1.55; 95%CI 0.97-2.47, P=0.067) though not significantly. CONCLUSION This study shows that after adjusting for sun exposure tall stature may be a risk factor for the most common types of skin cancer BCC, SCC, and melanoma, while body mass and surface area appear unrelated to risk.
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Affiliation(s)
- Petra H Lahmann
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Brisbane, Australia; Institute of Cancer Epidemiology, University of Lübeck, Lübeck, Germany.
| | - Maria Celia B Hughes
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Brisbane, Australia
| | - Gail M Williams
- School of Population Health, University of Queensland, Herston, Australia
| | - Adèle C Green
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Brisbane, Australia; Cancer Research UK Manchester Institute and University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
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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.
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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
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Verkouteren JA, Smedinga H, Steyerberg EW, Hofman A, Nijsten T. Predicting the Risk of a Second Basal Cell Carcinoma. J Invest Dermatol 2015; 135:2649-2656. [DOI: 10.1038/jid.2015.244] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/29/2015] [Accepted: 06/13/2015] [Indexed: 12/31/2022]
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Högnäs E, Kauppila A, Hinkula M, Tapanainen JS, Pukkala E. Incidence of cancer among grand multiparous women in Finland with special focus on non-gynaecological cancers: A population-based cohort study. Acta Oncol 2015. [PMID: 26217985 DOI: 10.3109/0284186x.2015.1063775] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Many studies have previously revealed evidence of an association between grand multiparity (five or more deliveries) and gynaecological cancer. Oestrogen has an impact on cancer formation and the amount of circulating oestrogen is significantly higher during pregnancy. Also the lifestyle of grand multiparous women differs somewhat from the average population. Considering these factors it is plausible that also non-gynaecological cancers are associated with multiparity. The aim of our study was to determine cancer incidence among grand multiparous women, with special attention to non-gynaecological cancers. MATERIAL AND METHODS All 102 541 women alive in 1974-2011 and having had at least five deliveries were identified in the Finnish Population Register and followed up for cancer incidence through the Finnish Cancer Registry to the end of 2011. Standardised incidence ratios (SIRs) were defined as ratios between observed and expected numbers of cases, the latter ones based on incidence in the entire Finnish female population. RESULTS The overall incidence of non-gynaecological cancers was the same as in the reference population (SIR 0.98, 95% confidence interval 0.90-1.06). The incidence of cancers of the gall-bladder (SIR 1.42, 1.26-1.58), biliary tract (1.19, 1.04-1.35) and kidney (1.22, 1.14-1.31) was increased. There were significantly fewer cases than expected of urinary bladder cancer (SIR 0.70, 0.61-0.78), lung cancer (0.87, 0.81-0.92), colon cancer (0.94, 0.89-0.99) and all types of skin cancers. As a consequence of the decreased incidence of gynaecological cancers (SIR 0.74, 0.71-0.77) and breast cancer (0.60, 0.58-0.61), the SIR for cancer overall was 0.84 (0.83-0.85). CONCLUSION The study demonstrated that grand multiparous women have a similar overall risk of non-gynaecological cancers as other women, despite significant differences in some specific forms of cancer.
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Affiliation(s)
- Emma Högnäs
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Antti Kauppila
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Marianne Hinkula
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Juha S. Tapanainen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
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Michal Freedman D, Kitahara CM, Linet MS, Alexander BH, Neta G, Little MP, Cahoon EK. Ambient temperature and risk of first primary basal cell carcinoma: A nationwide United States cohort study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 148:284-289. [PMID: 25996074 DOI: 10.1016/j.jphotobiol.2015.04.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/08/2015] [Accepted: 04/27/2015] [Indexed: 10/23/2022]
Abstract
The Earth's surface is warming and animal studies have shown higher temperatures promote ultraviolet radiation (UVR) skin carcinogenesis. There are, however, no population studies of long-term temperature exposure and basal cell carcinoma (BCC) risk. We linked average lifetime summer ambient temperatures (based on weather station data) and satellite-based UVR estimates to self-reported lifetime residences in the U.S. Radiologic Technologists' cohort. We assessed the relationship between time-dependent average lifetime summer ambient temperature (20-year lag) in quintiles and BCC in whites, using Cox proportional hazards regression. Risks were adjusted for time-dependent lagged average lifetime UVR and time outdoors, body mass index, eye color, and sex (baseline hazard stratified on birth cohort). During a median 19.4 years follow-up, we identified 3556 BCC cases. There was no significant trend in risk between temperature and BCC. However, BCC risk was highest in the fourth quintile of temperature (Q4 vs. Q1; hazards ratio (HR)=1.18; 95% confidence interval (CI)=1.06-1.31, p-trend=0.09). BCC risk was strongly related to average lifetime ambient UVR exposure (Q5 vs. Q1; HR=1.54 (95% CI=1.35-1.75, p-trend=<0.001)). Future studies of temperature and BCC risk should include a broad range of UVR and temperature values, along with improved indicators of exposure to temperatures and UVR.
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Affiliation(s)
- D Michal Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA.
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Gila Neta
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Mark P Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
| | - Elizabeth K Cahoon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA
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Obesity and risks for malignant melanoma and non-melanoma skin cancer: results from a large Danish prospective cohort study. J Invest Dermatol 2014; 135:901-904. [PMID: 25290686 DOI: 10.1038/jid.2014.438] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
OBJECTIVE To determine cancer incidence among Finnish women with 10 or more deliveries. METHODS Finnish women with at least 10 childbirths before December 31, 2010 (n=4,967) were identified from the Finnish Population Register and followed for cancer incidence through the Finnish Cancer Registry to the end of 2010. Cancer risks in this cohort were expressed as ratios between observed and expected numbers of cases (standardized incidence ratios), both drawn from the Finnish Cancer Registry, with 95% confidence intervals (CIs). RESULTS Total cancer incidence was markedly lower than in the reference population (656 cases, standardized incidence ratio 0.76, 95% CI 0.73-0.79). There was clearly less breast (0.44, 0.35-0.53), ovarian (0.49, 0.28-0.80), endometrial (0.31, 0.17-0.44), and basal cell skin cancer (0.72, 0.60-0.85) than in the reference population. The incidence of thyroid cancer (2.33, 1.59-3.29), lip cancer (2.87, 1.05-6.24), and uterine sarcoma (3.41, 1.47-6.72) was markedly increased. CONCLUSION Women with 10 or more deliveries show a decreased overall cancer incidence as a result of decreased risks of cancers of the ovary, endometrium, and breast and basal cell carcinoma of the skin. The increased risks were observed in thyroid cancer and some rare cancer types.
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Epidemiology of basal cell carcinoma in the United Kingdom: incidence, lifestyle factors, and comorbidities. Br J Cancer 2014; 111:203-6. [PMID: 24874476 PMCID: PMC4090732 DOI: 10.1038/bjc.2014.265] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/14/2014] [Accepted: 04/24/2014] [Indexed: 12/05/2022] Open
Abstract
Background: Little is known about the epidemiology of basal cell carcinoma (BCC). Methods: Using the Clinical Practice Research Datalink, we calculated annual incidence rates. In a case–control analysis, we examined lifestyle factors and comorbidities. Results: Incidence rose significantly between 2000 and 2011. Basal cell carcinoma risk was increased in alcohol drinkers (slightly) and immunocompromised patients, but reduced in smokers and individuals with abnormal weight. Conclusions: Basal cell carcinoma places a growing public health burden. Lifestyle factors do not play a major role in pathogenesis, but immunosuppression is important.
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Reeves GK, Balkwill A, Cairns BJ, Green J, Beral V. Hospital admissions in relation to body mass index in UK women: a prospective cohort study. BMC Med 2014; 12:45. [PMID: 24629170 PMCID: PMC4003825 DOI: 10.1186/1741-7015-12-45] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 03/05/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adiposity is associated with many adverse health outcomes but little direct evidence exists about its impact on the use of health care services. We aim to describe the relationship between body mass index (BMI) and rates of hospital admission in middle-aged UK women. METHODS Among 1,251,619 Million Women Study participants, 50- to 64-years old at entry into the study, routine data on hospital admissions were used to estimate hospitalization rates according to BMI after standardization for age, region of recruitment, socioeconomic status, reproductive history, smoking status, hormonal therapy use and alcohol intake. Proportional hazards models were used to estimate adjusted relative risks of hospitalization separately for 25 common types of admission. RESULTS During an average of 9.2 years follow-up, there were 2,834,016 incident hospital admissions. In women with BMIs (in kg/m2) of <22.5, 22.5 to <25, 25 to <30, 30 to <35 and 35+ standardized admission rates (and 95% confidence intervals (CIs)) per woman over a 10-year period were 2.4 (2.4 to 2.4), 2.4 (2.3 to 2.4), 2.6 (2.6 to 2.6), 3.0 (3.0 to 3.0) and 3.5 (3.4 to 3.5), respectively (P-value for heterogeneity <0.001). The relative increase in admission rates per 5 kg/m2 increase in BMI was 1.12 (1.12 to 1.13). This relationship did not vary materially by age. Corresponding average durations of stay (in days) per hospital visit within the same categories of BMI were: 3.1 (3.1 to 3.2), 2.8 (2.7 to 2.8), 2.9 (2.9 to 2.9), 3.2 (3.1 to 3.2) and 3.8 (3.7 to 3.8), respectively (P <0.001).Significant increases in the risk of admission with increasing BMI were observed for 19 of the 25 types of hospital admission considered. BMI was most strongly associated with admissions with diabetes, knee-replacement, gallbladder disease and venous thromboembolism, but marked associations were found with many other common categories of admission including cataracts, carpal tunnel syndrome and diverticulitis. CONCLUSIONS Among women 50- to 84-years old in England, around one in eight hospital admissions are likely to be attributable to overweight or obesity, translating to around 420,000 extra hospital admissions and two million extra days spent in hospital, annually.
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Affiliation(s)
- Gillian K Reeves
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Angela Balkwill
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Benjamin J Cairns
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Jane Green
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Valerie Beral
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UK
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Walter RB, Brasky TM, Buckley SA, Potter JD, White E. Height as an explanatory factor for sex differences in human cancer. J Natl Cancer Inst 2013; 105:860-8. [PMID: 23708052 PMCID: PMC3687370 DOI: 10.1093/jnci/djt102] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 01/26/2013] [Accepted: 02/28/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Most cancers occur more frequently in men. Numerous explanations for this excess risk have been proposed, yet no study has quantified the degree to which height explains the sex difference even though greater height has been associated with increased risk for many cancers. METHODS During the period from 2000 to 2002, 65308 volunteers aged 50 to 76 years were recruited to the Vitamins And Lifestyle (VITAL) study. Cancers of shared anatomic sites (n = 3466) were prospectively identified through 2009 through the Surveillance, Epidemiology, and End Results cancer registry. Age- and race-adjusted hazard ratios (HRs) for the associations between sex and incident cancers were estimated using Cox proportional hazards models, with and without adjustment for height and height squared as measures of body size. RESULTS Men had a 55% increased risk of cancer at shared sites (HR = 1.55; 95% confidence interval [CI] = 1.45 to 1.66). When height was accounted for, 33.8% (95% CI = 10.2% to 57.3%) of the excess risk for men was explained by the height differences between sexes. The proportion mediated by height was 90.9%, 57.3%, and 49.6% for kidney, melanoma, and hematologic malignancies, respectively, with little evidence that height mediates the sex difference for gastrointestinal tract, lung, and bladder cancers. For comparison, more than 35 lifestyle and medical risk factors only explained 23.1% of the sex difference in cancer risk at shared sites. CONCLUSIONS Height is an important explanatory factor for the excess risk for men for many shared-site cancers. This suggests that some of the excess risk is due to factors associated with height (eg, number of susceptible cells in a specific organ or growth-influencing exposures in childhood).
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Affiliation(s)
- Roland B Walter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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