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Tran MM, George-Washburn EA, Rhee J, Li WQ, Qureshi A, Cho E. A prospective cohort study exploring the joint influence of sunlight exposure and tanning bed use on basal cell carcinoma, squamous cell carcinoma, and melanoma risk. Arch Dermatol Res 2024; 316:281. [PMID: 38796657 DOI: 10.1007/s00403-024-03132-8] [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: 03/02/2024] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/28/2024]
Abstract
Exposure to solar ultraviolet (UV) radiation and use of UV-emitting tanning devices are known risk factors for skin cancer. Few studies have explored the interaction between these risk factors, namely how the risk of skin cancer increases among those who both have been exposed to high levels of natural sunlight and regularly use tanning beds. Nurses' Health Study II followed 116,430 women, aged 25-42, from 1991 to 2011. Cumulative average UV exposure was based on participants' residences at follow-up periods. History of severe sunburn during ages 15-20 was used as a proxy for early-life sunlight exposure. Tanning bed use in early life data was collected. Participants reported melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) diagnoses. We built multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of skin cancer associated with joint effects of sunlight exposure and tanning bed use. Participants with high sunlight exposure and tanning bed use during high school/college had an increased risk of BCC (HR = 1.53, 95% CI 1.37-1.71, Pinteraction=0.01; vs. low sun exposure and no tanning bed use). Participants with a history of severe sunburns and tanning bed use during high school/college were at increased risk of BCC (HR = 1.62, 95% CI 1.47-1.79, Pinteraction=0.02; vs. no sunburns and no tanning bed use). No significant interactions were found between sunlight exposure and tanning bed use on SCC and melanoma risk. We found significant interactions between sunlight exposure and tanning bed use on the risk of BCC.
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Affiliation(s)
- Megan M Tran
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | | | - Jongeun Rhee
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Wen-Qing Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Epidemiology, Brown School of Public Health, Providence, RI, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA.
- Department of Epidemiology, Brown School of Public Health, Providence, RI, USA.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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VoPham T, White AJ, Jones RR. Geospatial Science for the Environmental Epidemiology of Cancer in the Exposome Era. Cancer Epidemiol Biomarkers Prev 2024; 33:451-460. [PMID: 38566558 PMCID: PMC10996842 DOI: 10.1158/1055-9965.epi-23-1237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/11/2023] [Accepted: 01/29/2024] [Indexed: 04/04/2024] Open
Abstract
Geospatial science is the science of location or place that harnesses geospatial tools, such as geographic information systems (GIS), to understand the features of the environment according to their locations. Geospatial science has been transformative for cancer epidemiologic studies through enabling large-scale environmental exposure assessments. As the research paradigm for the exposome, or the totality of environmental exposures across the life course, continues to evolve, geospatial science will serve a critical role in determining optimal practices for how to measure the environment as part of the external exposome. The objectives of this article are to provide a summary of key concepts, present a conceptual framework that illustrates how geospatial science is applied to environmental epidemiology in practice and through the lens of the exposome, and discuss the following opportunities for advancing geospatial science in cancer epidemiologic research: enhancing spatial and temporal resolutions and extents for geospatial data; geospatial methodologies to measure climate change factors; approaches facilitating the use of patient addresses in epidemiologic studies; combining internal exposome data and geospatial exposure models of the external exposome to provide insights into biological pathways for environment-disease relationships; and incorporation of geospatial data into personalized cancer screening policies and clinical decision making.
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Affiliation(s)
- Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Alexandra J. White
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, Department of Health and Human Services, Bethesda, Maryland
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3
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Tran MM, George-Washburn EA, Rhee J, Li WQ, Qureshi A, Cho E. A Prospective Cohort Study Exploring the Joint Influence of Sunlight Exposure and Tanning Bed Use on Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma Risk. RESEARCH SQUARE 2024:rs.3.rs-4005623. [PMID: 38496529 PMCID: PMC10942498 DOI: 10.21203/rs.3.rs-4005623/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Exposure to solar ultraviolet (UV) radiation and use of UV-emitting tanning devices are known risk factors for skin cancer. Few studies have explored the interaction between these risk factors, namely how the risk of skin cancer increases among those who both have been exposed to high levels of natural sunlight and regularly use tanning beds. Nurses' Health Study II followed 116,430 women, aged 25-42, from 1991 to 2011. Cumulative average UV exposure was based on participants' residences at follow-up periods. History of severe sunburn during ages 15-20 was used as a proxy for early-life sunlight exposure. Tanning bed use in early life data was collected. Participants reported melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) diagnoses. We built multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of skin cancer associated with joint effects of sunlight exposure and tanning bed use. Participants with high sunlight exposure and tanning bed use during high school/college had an increased risk of BCC (HR=1.53, CI 1.37-1.71, P interaction =0.01; vs. low UV exposure and no tanning bed use). Participants with a history of severe sunburns and tanning bed use during high school/college were at increased risk of BCC (HR=1.62, CI 1.47-1.79, P interaction =0.02; vs. no sunburns and no tanning bed use). No significant interactions were found between sunlight exposure and tanning bed use on SCC and melanoma risk. We found significant interactions between sunlight exposure and tanning bed use on the risk of BCC.
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Affiliation(s)
- Megan M Tran
- The Warren Alpert Medical School of Brown University
| | | | - Jongeun Rhee
- The Warren Alpert Medical School of Brown University
| | - Wen-Qing Li
- The Warren Alpert Medical School of Brown University
| | - Abrar Qureshi
- The Warren Alpert Medical School of Brown University
| | - Eunyoung Cho
- The Warren Alpert Medical School of Brown University
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4
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Carroll R, Ish JL, Sandler DP, White AJ, Zhao S. Understanding the role of environmental and socioeconomic factors in the geographic variation of breast cancer risk in the US-wide Sister Study. ENVIRONMENTAL RESEARCH 2023; 239:117349. [PMID: 37821066 PMCID: PMC10841999 DOI: 10.1016/j.envres.2023.117349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To describe the geographic pattern of breast cancer incidence in a nationwide prospective cohort and investigate whether environmental exposures and/or neighborhood socioeconomic status explain observed geographic disparities. METHODS Using accelerated failure time models with a spatial random effect term, we mapped the health region-level association between residential location and breast cancer incidence for 44,707 participants in the Sister Study after controlling for established individual-level breast cancer risk factors. We performed a variable selection process to select environmental exposures [i.e., ambient nitrogen dioxide (NO2) and fine particulate matter (PM2.5), PM2.5 chemical composition, outdoor light at night (LAN), ambient noise, ultraviolet radiation, and greenspace] and neighborhood-level factors [i.e., population density and area deprivation index (ADI)] that predicted breast cancer incidence and quantified the spatial variation explained by the selected factors. We also considered whether the geographic pattern and predictors were similar when restricting to estrogen receptor-positive (ER+) tumors. RESULTS We observed a spatial patterning in the incidence of overall breast cancer (Moran's I = 16.7, p < 0.05) and ER+ breast cancer (Moran's I = 13.2, p < 0.05), with a lower risk observed in the South and Southeast and a greater risk in the Northwest and certain areas of the Midwest and Northeast. NO2, LAN, and ADI explained 21.4% of the spatial variation in overall breast cancer incidence whereas NO2, PM2.5 chemical composition, LAN, greenspace, and ADI together explained 63.3% of the spatial variation in ER+ breast cancer incidence. CONCLUSIONS Our findings provide additional evidence for a role of environmental exposures in breast cancer incidence and suggest that geographic-based risk factors may vary according to breast cancer subtype. Our findings support the need for additional research to quantify the relative contributions of geographic-based risk factors for breast cancer.
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Affiliation(s)
- Rachel Carroll
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA; Human Services Division, American Institutes for Research, 400 Crystal Drive 10th Floor, Arlington, VA, 22202, USA
| | - Jennifer L Ish
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA.
| | - Shanshan Zhao
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, 111 TW Alexander Dr, Durham, NC, 27709, USA
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Hu H, Liu X, Zheng Y, He X, Hart J, James P, Laden F, Chen Y, Bian J. Methodological Challenges in Spatial and Contextual Exposome-Health Studies. CRITICAL REVIEWS IN ENVIRONMENTAL SCIENCE AND TECHNOLOGY 2023; 53:827-846. [PMID: 37138645 PMCID: PMC10153069 DOI: 10.1080/10643389.2022.2093595] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The concept of the exposome encompasses the totality of exposures from a variety of external and internal sources across an individual's life course. The wealth of existing spatial and contextual data makes it appealing to characterize individuals' external exposome to advance our understanding of environmental determinants of health. However, the spatial and contextual exposome is very different from other exposome factors measured at the individual-level as spatial and contextual exposome data are more heterogenous with unique correlation structures and various spatiotemporal scales. These distinctive characteristics lead to multiple unique methodological challenges across different stages of a study. This article provides a review of the existing resources, methods, and tools in the new and developing field for spatial and contextual exposome-health studies focusing on four areas: (1) data engineering, (2) spatiotemporal data linkage, (3) statistical methods for exposome-health association studies, and (4) machine- and deep-learning methods to use spatial and contextual exposome data for disease prediction. A critical analysis of the methodological challenges involved in each of these areas is performed to identify knowledge gaps and address future research needs.
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Affiliation(s)
- Hui Hu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Xiaokang Liu
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yi Zheng
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Xing He
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Jaime Hart
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Pilgrim Healthcare, Boston, Massachusetts, USA
| | - Francine Laden
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Yong Chen
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
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Li H, Hart JE, Mahalingaiah S, Nethery RC, James P, Bertone-Johnson E, Eliassen AH, Laden F. Environmental Exposures and Anti-Müllerian Hormone: A Mixture Analysis in the Nurses' Health Study II. Epidemiology 2023; 34:150-161. [PMID: 36455251 PMCID: PMC9720700 DOI: 10.1097/ede.0000000000001547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Previous studies have linked environmental exposures with anti-Müllerian hormone (AMH), a marker of ovarian reserve. However, associations with multiple environment factors has to our knowledge not been addressed. METHODS We included a total of 2,447 premenopausal women in the Nurses' Health Study II (NHSII) who provided blood samples during 1996-1999. We selected environmental exposures linked previously with reproductive outcomes that had measurement data available in NHSII, including greenness, particulate matter, noise, outdoor light at night, ultraviolet radiation, and six hazardous air pollutants (1,3-butadiene, benzene, diesel particulate matter, formaldehyde, methylene chloride, and tetrachloroethylene). For these, we calculated cumulative averages from enrollment (1989) to blood draw and estimated associations with AMH in adjusted single-exposure models, principal component analysis (PCA), and hierarchical Bayesian kernel machine regression (BKMR). RESULTS Single-exposure models showed negative associations of AMH with benzene (percentage reduction in AMH per interquartile range [IQR] increase = 5.5%, 95% confidence interval [CI] = 1.0, 9.8) and formaldehyde (6.1%, 95% CI = 1.6, 10). PCA identified four major exposure patterns but only one with high exposure to air pollutants and light at night was associated with lower AMH. Hierarchical BKMR pointed to benzene, formaldehyde, and greenness and suggested an inverse joint association with AMH (percentage reduction comparing all exposures at the 75th percentile to median = 8.2%, 95% CI = 0.7, 15.1). Observed associations were mainly among women above age 40. CONCLUSIONS We found exposure to benzene and formaldehyde to be consistently associated with lower AMH levels. The associations among older women are consistent with the hypothesis that environmental exposures accelerate reproductive aging.
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Affiliation(s)
- Huichu Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Rachel C. Nethery
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Elizabeth Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Chang MS, Hartman RI, Trepanowski N, Giovannucci EL, Nan H, Li X. Cumulative Erythemal Ultraviolet Radiation and Risk of Cancer in 3 Large US Prospective Cohorts. Am J Epidemiol 2022; 191:1742-1752. [PMID: 35671977 PMCID: PMC9991893 DOI: 10.1093/aje/kwac101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 05/20/2022] [Accepted: 06/01/2022] [Indexed: 01/29/2023] Open
Abstract
Ultraviolet radiation (UVR) exposure is the major risk factor for melanoma. However, epidemiologic studies on UVR and noncutaneous cancers have reported inconsistent results, with some suggesting an inverse relationship potentially mediated by vitamin D. To address this, we examined 3 US prospective cohorts, the Health Professionals Follow-up Study (HPFS) (1986) and Nurses' Health Study (NHS) I and II (1976 and 1989), for associations between cumulative erythemal UVR and incident cancer risk, excluding nonmelanoma skin cancer. We used a validated spatiotemporal model to calculate erythemal UVR. Participants (47,714 men; 212,449 women) were stratified into quintiles by cumulative average erythemal UVR, using the first quintile as referent, for Cox proportional hazards regression analysis. In the multivariable-adjusted meta-analysis of all cohorts, compared with the lowest quintile, risk of any cancer was slightly increased across all other quintiles (highest quintile hazard ratio (HR) = 1.04, 95% confidence interval (CI): 1.01, 1.07; P for heterogeneity = 0.41). All UVR quintiles were associated with similarly increased risk of any cancer excluding melanoma. As expected, erythemal UVR was positively associated with risk of melanoma (highest quintile HR = 1.17, 95% CI: 1.04, 1.31; P for heterogeneity = 0.83). These findings suggest that elevated UVR is associated with increased risk of both melanoma and noncutaneous cancers.
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Affiliation(s)
| | | | | | | | | | - Xin Li
- Correspondence to Dr. Xin Li, Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Health Sciences Building, RG 5114, 1050 Wishard Boulevard., Indianapolis, IN 46202 (e-mail: )
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Barbhaiya M, Hart JE, Malspeis S, Tedeschi SK, VoPham T, Sparks JA, Karlson EW, Laden F, Costenbader KH. Association of Ultraviolet B Radiation and Risk of Systemic Lupus Erythematosus Among Women in the Nurses' Health Studies. Arthritis Care Res (Hoboken) 2022:10.1002/acr.24974. [PMID: 35724272 PMCID: PMC9910058 DOI: 10.1002/acr.24974] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 06/02/2022] [Accepted: 06/16/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Ultraviolet (UV) radiation exposure is associated with photosensitivity, rashes, and flares in systemic lupus erythematosus (SLE). However, it is not known whether UV exposure increases risk of developing SLE. We examined UV exposure and SLE risk in a large prospective cohort. METHODS The Nurses' Health Study (NHS) enrolled 121,700 US female nurses in 1976; in 1989, 116,429 nurses were enrolled in NHS II. Biennial questionnaires collected lifestyle and medical data. Self-reported incident SLE by American College of Rheumatology classification criteria was confirmed by medical record review. Ambient UV exposure was estimated by linking geocoded residential addresses with a spatiotemporal UV exposure model. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) across tertiles of time-varying cumulative average UV. We examined SLE risk overall and stratified by anti-Ro/La antibodies and by cutaneous manifestations from 1976 through 2014 (NHS)/2015 (NHS II), adjusting for confounders. RESULTS With 6,054,665 person-years of exposure, we identified 297 incident SLE cases; the mean ± SD age at diagnosis was 49.8 ± 10.6 years. At diagnosis, 16.8% of women had +anti-Ro/La, and 80% had either +anti-Ro/La or ≥1 cutaneous manifestation. Compared with the lowest UV exposure tertile, risk of overall SLE was increased, but not significantly (HR 1.28 [95%CI 0.96-1.70]). Women in the highest tertile had increased risk of malar rash (HR 1.62 [95% CI 1.04-2.52]). CONCLUSION Cumulative UV exposure was not associated with SLE risk. Higher UV exposure, however, was associated with increased risk of malar rash at presentation. UV exposure may trigger SLE onset with malar rash among susceptible women.
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Affiliation(s)
- Medha Barbhaiya
- Division of Rheumatology, Hospital For Special Surgery, New York, NY,Departments of Medicine and Population Health Sciences, Weill Cornell Medicine, New York, NY
| | - Jaime E. Hart
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Susan Malspeis
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Sara K. Tedeschi
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Boston, MA
| | - Jeffrey A. Sparks
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Elizabeth W. Karlson
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Francine Laden
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Karen H. Costenbader
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
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VoPham T, Bertrand KA, Fisher JA, Ward MH, Laden F, Jones RR. Emissions of dioxins and dioxin-like compounds and incidence of hepatocellular carcinoma in the United States. ENVIRONMENTAL RESEARCH 2022; 204:112386. [PMID: 34800530 PMCID: PMC8671236 DOI: 10.1016/j.envres.2021.112386] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 05/07/2023]
Abstract
Ambient dioxin exposure from industrial sources, excluding exposures from occupations and accidental releases/contamination, may be associated with risk of developing hepatocellular carcinoma (HCC). The objective of this study was to examine the association between county-level ambient dioxin air emissions from industrial sources and HCC risk in the US. We obtained information on 90,359 incident HCC cases diagnosed between 2000 and 2016 from population-based cancer registries across the US in the Surveillance, Epidemiology, and End Results (SEER) database. Dioxin emissions from 1987 to 2007 from a nationwide spatial database of historical dioxin-emitting facilities were linked to the SEER county of residence at diagnosis using a geographic information system (GIS). Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between county-level dioxin emissions and HCC rates adjusting for individual-level age at diagnosis, sex, race/ethnicity, year of diagnosis, SEER registry, and county-level information on health conditions, lifestyle factors, and socioeconomic status. There was no association between dioxin emissions based on the number of dioxin-emitting facilities within a county or average annual emissions within a county and HCC risk. In analyses by facility type, there were positive associations between county-level dioxin emissions from coal-fired power plants (adjusted IRR 1.09, 95% CI 1.01-1.17), but not with the number of these facilities. Similarly, positive associations for industrial boilers and sewage sludge incinerators were evident, but not consistent across both exposure metrics. Future research should incorporate individual-level data to further explore the findings suggested by these ecologic analyses.
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Affiliation(s)
- Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, Seattle, WA, 98109, United States; Department of Epidemiology, University of Washington School of Public Health, 3980 15th Avenue NE, Seattle, WA, 98195, United States.
| | - Kimberly A Bertrand
- Slone Epidemiology Center at Boston University, 72 East Concord Street L-7, Boston, MA, 02118, United States
| | - Jared A Fisher
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive MSC 9776, Bethesda, MD, 20850, United States
| | - Mary H Ward
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive MSC 9776, Bethesda, MD, 20850, United States
| | - Francine Laden
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA, 02115, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, United States
| | - Rena R Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive MSC 9776, Bethesda, MD, 20850, United States
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10
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Yen H, Yen H, Drucker AM, Han J, Li WQ, Li T, Qureshi A, Cho E. COX‐2‐Hemmer: Keine präventive Wirkung gegen Hautkrebs. J Dtsch Dermatol Ges 2022; 20:157-168. [PMID: 35146873 DOI: 10.1111/ddg.14649_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/10/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Hsuan Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsi Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Dermatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.,Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA
| | - Wen-Qing Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Tricia Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.,Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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11
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Yen H, Yen H, Drucker AM, Han J, Li WQ, Li T, Qureshi A, Cho E. COX-2 inhibitors show no preventive effect in the development of skin cancer. J Dtsch Dermatol Ges 2022; 20:157-166. [PMID: 35088518 PMCID: PMC9208635 DOI: 10.1111/ddg.14649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/10/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Some clinical trials found that cyclooxygenase-2 (COX-2) inhibitor use lowered the risk of skin cancer in high-risk groups. PATIENTS AND METHODS To determine whether COX-2 inhibitor use is associated with lower risk of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC), and melanoma, we analyzed COX-2 inhibitor use and risk of skin cancer based on three prospective cohort studies, the Nurses' Health Study (NHS), NHS II, and the Health Professionals Follow-up Study, including 153,882 participants. Multivariable hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association of COX-2 inhibitor use with risk of BCC, cSCC, and melanoma were estimated using Cox proportional hazards models. We pooled the results using a fixed effects model. RESULTS 16,142 BCC, 1,973 cSCC, and 631 melanoma cases were documented. Ever vs. never use of COX-2 inhibitor was associated with a modestly increased risk of BCC (multivariable HR 1.09, 95 % CI 1.05-1.14). The hazard ratio was similar for cSCC (multivariable HR 1.12, 95 % CI 1.00-1.27) and melanoma (multivariable HR 1.10, 95 % CI 0.89-1.38), but was not statistically significant. CONCLUSIONS Ever use of COX-2 inhibitor was not associated with a decreased skin cancer risk but was instead associated with a modest, increased risk of BCC.
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Affiliation(s)
- Hsuan Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsi Yen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Dermatology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Aaron M. Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute and Department of Medicine, Women’s College Hospital, Toronto, Ontario, Canada
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA
| | - Wen-Qing Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Tricia Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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12
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Gregoire AM, VoPham T, Laden F, Yarosh R, O'Brien KM, Sandler DP, White AJ. Residential ultraviolet radiation and breast cancer risk in a large prospective cohort. ENVIRONMENT INTERNATIONAL 2022; 159:107028. [PMID: 34894486 PMCID: PMC8748390 DOI: 10.1016/j.envint.2021.107028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/23/2021] [Accepted: 12/03/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Ambient ultraviolet (UV) radiation has been increasing due to climate change. While this may result in adverse health consequences such as an increased incidence of skin cancer, UV radiation is also a source of vitamin D, which has been hypothesized to be protective for breast cancer risk. METHODS Using a spatiotemporal kriging model, we estimated residential UV exposure levels for the enrollment addresses (2003-2009) of breast cancer-free women aged 35-74 years participating in the Sister Study and living in the contiguous United States (N = 48,450). Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the risk associated with UV exposure levels (mW/m2) categorized in quintiles. We examined the association for breast cancer overall (invasive and ductal carcinoma in situ) and by estrogen receptor (ER) status of the tumor. We considered effect modification by regular (≥4 times/week) vitamin D supplement use. RESULTS Over a median of 10.5 years of follow up, 3,510 incident breast cancer diagnoses were reported. We found no evidence of an association between living in areas with higher levels of UV radiation and overall breast cancer risk (HRQ5 vs. Q1 = 1.00, 95% CI: 0.90, 1.11). Higher UV levels were inversely associated with the risk of ER- breast cancer (HRQ5 vs. Q1 = 0.73, 95% CI: 0.55-0.99), but not ER+ (HR Q5 vs. Q1 = 1.04, 95% CI: 0.92-1.18). For ER- breast cancer, the inverse association was only evident in women who did not regularly take vitamin D supplements (HRQ5 vs. Q1 = 0.52, 95% CI: 0.33-0.81) compared with those who did regularly take vitamin D supplements (HRQ5 vs. Q1 = 1.02, 95% CI: 0.68-1.54; p-for-heterogeneity = 0.12). CONCLUSIONS The findings from this study support a role for UV exposure and vitamin D in the etiology of ER- breast cancer.
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Affiliation(s)
- Allyson M Gregoire
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Rina Yarosh
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Alexandra J White
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
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13
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Li H, Hart JE, Mahalingaiah S, Nethery RC, VoPham T, Bertone-Johnson E, Laden F. Ultraviolet radiation and age at natural menopause in a nationwide, prospective US cohort. ENVIRONMENTAL RESEARCH 2022; 203:111929. [PMID: 34428453 PMCID: PMC8616785 DOI: 10.1016/j.envres.2021.111929] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Solar ultraviolet radiation (UV) is a critical environmental factor for dermal conversion of vitamin D, which is suggested to support reproductive health. However, current epidemiological studies have reported conflicting results on the associations between vitamin D levels and ovarian reserve. Further, few studies have considered UV exposure and reproductive aging, which is closely related to declined ovarian reserve. OBJECTIVES We sought to examine the associations of long-term UV exposure and age at natural menopause in a large, nationwide, prospective cohort. METHODS Participants in the Nurses' Health Study II (NHS II) who were premenopausal at age 40 were included and followed through 2015. Erythemal UV radiation from a high-resolution geospatial model was linked to the participants' residential histories. Early-life UV was estimated using the reported state of residence at birth, age 15, and age 30. We used time-varying Cox proportional hazards models to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) for natural menopause, adjusting for potential confounders and predictors of menopause. RESULTS A total of 63,801 women reported natural menopause across the 1,051,185 person-years of follow-up among 105,631 eligible participants. We found very modest associations with delayed menopause for long-term UV exposure (adjusted HR comparing highest to lowest quartile of cumulative average UV: 0.96, 95% CI: 0.94, 0.99). There was a suggestive inverse association between UV at age 30 with menopause (adjusted HR comparing highest to lowest quartile: 0.97, 95% CI: 0.95, 1.00) but not with UV at birth and age 15. CONCLUSIONS Solar UV exposure in adulthood was modestly associated with later onset of menopause. Although consistent with previous findings on vitamin D intake and menopause in the same population, these weak associations found in this study may not be of clinical relevance.
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Affiliation(s)
- Huichu Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - Jaime E Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Rachel C Nethery
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Trang VoPham
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Elizabeth Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA; Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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14
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Li Y, Li WQ, Li T, Qureshi AA, Cho E. Eye color and the risk of skin cancer. Cancer Causes Control 2021; 33:109-116. [PMID: 34687387 DOI: 10.1007/s10552-021-01508-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
Melanoma, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common skin cancers. The incidence rates of all three types of skin cancers have increased in the past three decades. Light pigmentary traits have been recognized as one of the host risk factors for skin cancer, but findings on associations between eye colors and risk of skin cancers have been inconsistent.We performed a prospective analysis to examine the association between eye colors and risk of skin cancers using the Health Professionals Follow-up Study (HPFS). Cox proportional hazard models were applied to estimate relative risks (RRs) and their 95% confidence intervals (CIs). Effect modifications due to hair color and skin reaction to sun were also examined.The HPFS included 35,662 males. During a median follow-up of 19 years (1988-2012), 445 melanoma, 1123 SCC, and 7198 BCC cases were documented. Compared to those whose eye colors were dark or brown, participants with hazel/green/medium and blue/light colors had a 24% (RR = 1.24, 95% CI: 1.06-1.45) and a 19% (RR = 1.19, 95% CI: 1.01-1.41) higher risk of SCC, respectively. Similarly, a higher risk of BCC was observed in participants with hazel/green/medium eye colors (RR = 1.16, 95% CI: 1.09-1.23) and blue/light eye colors (RR = 1.17, 95% CI: 1.10-1.25). We did not find significant associations between eye color and risk of melanoma. Lighter eye color was associated with increased risks of SCC and BCC among those with dark hair colors (p for interaction ≤ 0.02).In conclusion, in this large prospective study of men, we found that light eye colors were associated with higher risks of SCC and BCC, but not melanoma. Further studies are needed to confirm this association in other populations.
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Affiliation(s)
- Yueyao Li
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Wen-Qing Li
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.,Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China.,Department of Epidemiology, Brown School of Public Health, Providence, RI, USA
| | - Tricia Li
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Womens Hospital, Boston, MA, USA
| | - Abrar A Qureshi
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.,Department of Epidemiology, Brown School of Public Health, Providence, RI, USA
| | - Eunyoung Cho
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA. .,Department of Epidemiology, Brown School of Public Health, Providence, RI, USA. .,Channing Division of Network Medicine, Department of Medicine, Brigham and Womens Hospital, Boston, MA, USA.
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15
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Ton M, Widener MJ, James P, VoPham T. Food Environments and Hepatocellular Carcinoma Incidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115740. [PMID: 34071856 PMCID: PMC8198353 DOI: 10.3390/ijerph18115740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/17/2023]
Abstract
Research into the potential impact of the food environment on liver cancer incidence has been limited, though there is evidence showing that specific foods and nutrients may be potential risk or preventive factors. Data on hepatocellular carcinoma (HCC) cases were obtained from the Surveillance, Epidemiology, and End Results (SEER) cancer registries. The county-level food environment was assessed using the Modified Retail Food Environment Index (mRFEI), a continuous score that measures the number of healthy and less healthy food retailers within counties. Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between mRFEI scores and HCC risk, adjusting for individual- and county-level factors. The county-level food environment was not associated with HCC risk after adjustment for individual-level age at diagnosis, sex, race/ethnicity, year, and SEER registry and county-level measures for health conditions, lifestyle factors, and socioeconomic status (adjusted IRR: 0.99, 95% CI: 0.96, 1.01). The county-level food environment, measured using mRFEI scores, was not associated with HCC risk.
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Affiliation(s)
- Mimi Ton
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Seattle, WA 98195, USA;
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
- Correspondence: ; Tel.: +1-503-810-8842
| | - Michael J. Widener
- Department of Geography and Planning, University of Toronto, 100 St. George Street, Toronto, ON M5S 3G3, Canada;
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Boston, MA 02215, USA;
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA
| | - Trang VoPham
- Department of Epidemiology, University of Washington School of Public Health, 3980 15th Ave NE, Seattle, WA 98195, USA;
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109, USA
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16
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Farland LV, Degnan WJ, Harris HR, Han J, Cho E, VoPham T, Kvaskoff M, Missmer SA. Recreational and residential sun exposure and risk of endometriosis: a prospective cohort study. Hum Reprod 2021; 36:199-210. [PMID: 33432329 DOI: 10.1093/humrep/deaa280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/22/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is recreational and residential sun exposure associated with risk of endometriosis? SUMMARY ANSWER Tanning bed use in early adulthood, sunscreen use and history of sunburns were associated with a greater risk of endometriosis; however, higher residential UV exposure was associated with a lower endometriosis risk. WHAT IS KNOWN ALREADY Previous research has reported an association between endometriosis and skin cancer, with evidence of shared risk factors between the two diseases. We investigated the potential associations between ultraviolet radiation and endometriosis risk. STUDY DESIGN, SIZE, DURATION The Nurses' Health Study II is a prospective cohort of 116 429 female US nurses aged 25-42 years at enrolment in 1989. Participants completed self-administered biennial questionnaires through June 2015. PARTICIPANTS/MATERIALS, SETTINGS, METHODS We investigated self-reported measures of recreational sun-exposure and geocoded residential UV exposure in childhood and adulthood in relation to risk of laparoscopically confirmed endometriosis among premenopausal white women. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% CIs. MAIN RESULTS AND THE ROLE OF CHANCE During follow-up, 4791 incident cases of laparoscopically confirmed endometriosis were reported among 1 252 248 person-years. Tanning bed use during high school/college (≥6 times per year vs. never use: HR = 1.19, 95% CI = 1.01-1.40; Ptrend = 0.04) and at ages 25-35 (HR = 1.24, 95% CI = 1.12-1.39; Ptrend ≤ 0.0001), number of sunburns during adolescence (Ptrend = 0.03) and percentage of time using sunscreen in adulthood (Ptrend = 0.002) were positively associated with risk of endometriosis. In contrast, residential UV level at birth (highest vs. lowest quintile: HR = 0.81, 95% CI = 0.72-0.92; Ptrend = 0.0001), at age 15 (HR = 0.79, 95% CI = 0.70-0.88; Ptrend ≤ 0.0001) and at age 30 (HR = 0.90, 95% CI = 0.82-0.99; Ptrend = 0.21) were associated with a decreased risk of endometriosis. LIMITATIONS, REASONS FOR CAUTION Self-reported endometriosis diagnosis may be prone to misclassification; however, we restricted our definition to laparoscopically confirmed endometriosis, which has been shown to have high validity compared to medical records. WIDER IMPLICATIONS OF THE FINDINGS Our results suggest that tanning bed use in early adulthood increases endometriosis risk, potentially through a harmful effect of ultraviolet A wavelengths, and that residential UV exposure reduces risk, possibly via optimal vitamin D synthesis. These findings should be investigated further to enhance our understanding of endometriosis aetiology. STUDY FUNDING/COMPETING INTEREST(S) This project was supported by NICHD grants HD48544 and HD52473, HD57210, NIH grant CA50385, CA176726. M.K. was supported by a Marie Curie International Outgoing Fellowship within the 7th European Community Framework Programme (#PIOF-GA-2011-302078) and is grateful to the Philippe Foundation and the Bettencourt-Schueller Foundation for their financial support. H.R.H. is supported by the National Cancer Institute, National Institutes of Health (K22 CA193860). The authors have nothing to disclose. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - William J Degnan
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Holly R Harris
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Jiali Han
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.,Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, RI, USA.,Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.,Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marina Kvaskoff
- School of Medicine, Université Versailles Saint-Quentin-en-Yvelines (UVSQ), INSERM (French National Institute for Health and Medical Research), Université Paris Saclay, Villejuif, France.,Gustave Roussy, Villejuif, France
| | - Stacey A Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Abstract
PRECIS In a cohort study of 120,307 participants with 25+ years of follow-up, a history of nonmelanoma skin cancer (NMSC) was associated with a 40% higher exfoliation glaucoma (XFG) risk. PURPOSE The purpose of this study was to evaluate the relationship between NMSC (a marker of ultraviolet radiation exposure) and XFG. METHODS We performed a cohort study of US women (n=79,102; 1980-2014) and men (n=41,205; 1986-2014), aged 40+ years and at risk for glaucoma who reported eye examinations. From 1984 (women)/1988 (men), we asked about basal cell carcinoma or squamous cell carcinoma history separately; in prior years, we asked about any NMSC history in a single question. Squamous cell carcinoma was confirmed with histopathology reports while basal cell carcinoma and any early (<1984/<1988) NMSC history was self-reported. Incident XFG cases (362 women and 83 men) were confirmed with medical records. Using pooled data, we estimated multivariable-adjusted relative risks [MVRRs; 95% confidence intervals (CIs)] with Cox proportional hazards models that were stratified by age (in mo), 2-year time period at risk and average lifetime residential latitude. RESULTS In multivariable-adjusted analyses, we observed a 40% higher XFG risk with any NMSC history (MVRR=1.40; 95% CI=1.08-1.82); the association was observed even with 4 and 8-year lags in NMSC history. Also, the NMSC association was stronger in younger (below 65 y; MVRR=2.56; 95% CI=1.62-4.05) versus older participants (65 y and above; MVRR=1.25; 95% CI=0.94-1.66; P for interaction=0.01) and those living in the northern latitudes (≥42°N; MVRR=1.92; 95% CI=1.28-2.88) versus more southern latitudes (<42°N; MVRR=1.19; 95% CI=0.86-1.66; P for interaction=0.04). CONCLUSION NMSC was associated with higher XFG risk, particularly among younger participants and those living in the Northern US.
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18
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Hartman RI, Tang H, Hang D, Song M, Nan H, Li X. Red Hair Color Is Associated with Elevated CRP Levels among US Women. J Invest Dermatol 2020; 141:1342-1344. [PMID: 33058862 DOI: 10.1016/j.jid.2020.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Rebecca I Hartman
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Dermatology, VA Integrated Service Network (VISN-1), Boston, Massachusetts, USA
| | - Huilin Tang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
| | - Dong Hang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Mingyang Song
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA
| | - Xin Li
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA.
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19
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Zhang Y, Birmann BM, Han J, Giovannucci EL, Speizer FE, Stampfer MJ, Rosner BA, Schernhammer ES. Personal use of permanent hair dyes and cancer risk and mortality in US women: prospective cohort study. BMJ 2020; 370:m2942. [PMID: 32878860 PMCID: PMC7463170 DOI: 10.1136/bmj.m2942] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the associations between personal use of permanent hair dyes and cancer risk and mortality. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS 117 200 women enrolled in the Nurses' Health Study, an ongoing prospective cohort study of female nurses in the United States. The women were free of cancer at baseline, reported information on personal use of permanent hair dyes, and were followed for 36 years. EXPOSURE Status, duration, frequency, and integral use (cumulative dose calculated from duration and frequency) of permanent hair dyes. Age at first use and time since first use of permanent hair dyes. MAIN OUTCOME MEASURES Associations of personal use of permanent hair dyes with risk of overall cancer and specific cancers, and cancer related death. Age and multivariable adjusted hazard ratios and 95% confidence intervals were estimated by using Cox proportional hazard models. RESULTS Ever users of permanent hair dyes had no significant increases in risk of solid cancers (n=20 805, excluding non-melanoma skin cancers; hazard ratio 0.98, 95% confidence interval 0.96 to 1.01) or hematopoietic cancers overall (n=1807; 1.00, 0.91 to 1.10) compared with non-users. Additionally, ever users did not have an increased risk of most specific cancers (cutaneous squamous cell carcinoma, bladder cancer, melanoma, estrogen receptor positive breast cancer, progesterone receptor positive breast cancer, hormone receptor positive breast cancer, brain cancer, colorectal cancer, kidney cancer, lung cancer, and most of the major subclasses and histological subtypes of hematopoietic cancer) or cancer related death (n=4860; 0.96, 0.91 to 1.02). Basal cell carcinoma risk was slightly increased for ever users (n=22 560; 1.05, 1.02 to 1.08). Cumulative dose was positively associated with risk of estrogen receptor negative breast cancer, progesterone receptor negative breast cancer, hormone receptor negative breast cancer, and ovarian cancer. An increased risk of Hodgkin lymphoma was observed only for women with naturally dark hair (based on 70 women, 24 with dark hair), and a higher risk of basal cell carcinoma was observed for women with naturally light hair. CONCLUSION No positive association was found between personal use of permanent hair dye and risk of most cancers and cancer related mortality. The increased risk of basal cell carcinoma, breast cancer (estrogen receptor negative, progesterone receptor negative, hormone receptor negative) and ovarian cancer, and the mixed findings in analyses stratified by natural hair color warrant further investigation.
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Affiliation(s)
- Yin Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Brenda M Birmann
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jiali Han
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Richard M Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
- Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN, USA
| | - Edward L Giovannucci
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Frank E Speizer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Meir J Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Eva S Schernhammer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Lam T, VoPham T, Munger KL, Laden F, Hart JE. Long-term effects of latitude, ambient temperature, and ultraviolet radiation on the incidence of multiple sclerosis in two cohorts of US women. Environ Epidemiol 2020; 4:e0105. [PMID: 32903352 PMCID: PMC7431017 DOI: 10.1097/ee9.0000000000000105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/16/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Differences in multiple sclerosis (MS) risk by latitude have been observed worldwide; however, the exposures driving these associations are unknown. Ultraviolet radiation (UV) has been explored as a risk factor, and ambient temperature has been correlated with disease progression. However, no study has examined the impact of all three exposures. We examined the association between these exposures and incidence of MS within two nationwide prospective cohorts of women, the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII). METHODS Both cohorts were followed with biennial questionnaires to ascertain new diagnoses and risk factors. Time-varying exposures to latitude, cumulative average July temperature (°C), and cumulative average July erythemal UV (mW/m2) were predicted at each participant's biennially updated residential addresses. Using Cox proportional hazards models adjusted for MS risk factors, we calculated hazard ratios (HR) and 95% confidence intervals (CIs) within each cohort and pooled via meta-analyses. RESULTS In multivariable models, there were suggestions that decreasing latitude (meta-analysis multivariable-adjusted HR = 0.72; 95% CI 0.55, 0.94 for women living <35.73° compared with those ≥42.15°, P-for-trend = 0.007) and increasing cumulative average July temperature (meta-analysis multivariable-adjusted HR = 0.81; 95% CI 0.72, 0.91 for each interquartile range increase [3.91°]) were associated with decreasing risk of MS. There was no evidence of heterogeneity between cohorts. We did not observe consistent associations with cumulative average UV. CONCLUSION Our results suggest that adult exposures to decreasing latitude and increasing temperature, but not UV, were associated with reduced MS risk in these two cohorts of women. Studies of MS incidence may want to consider temperature as a risk factor.
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Affiliation(s)
- Thao Lam
- Graduate School of Life Sciences, Utrecht University, Utrecht, the Netherlands
| | - Trang VoPham
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Kassandra L. Munger
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
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Li X, Kraft P, De Vivo I, Giovannucci E, Liang L, Nan H. Height, nevus count, and risk of cutaneous malignant melanoma: Results from 2 large cohorts of US women. J Am Acad Dermatol 2020; 83:1049-1056. [PMID: 32376423 DOI: 10.1016/j.jaad.2020.04.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 04/08/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Taller individuals are at higher risk of melanoma. OBJECTIVE To prospectively investigate the association of height with nevus count and melanoma and estimate the proportion of height-melanoma association explained by nevus count among white participants from the Nurses' Health Study (NHS) and Nurses' Health Study 2 (NHS2). METHODS We used Cox proportional hazards regression and multinomial logistic regression for data analyses, with adjustment of potential confounders in the multivariate model. RESULTS We included 82,468 and 106,069 women from NHS and NHS2, respectively. The hazard ratio was 1.21 (95% confidence interval [CI] 1.12-1.31) for the association between every 10-cm increase in height and melanoma. Compared with women with no nevi, the odds ratios (95% CIs) associated with a 10-cm increase in height were 1.35 (95% CI 1.23-1.48) in the NHS and 1.12 (95% CI 1.09-1.15) in the NHS2 for women with greater than or equal to 10 moles. The proportion of excess melanoma risk associated with each 10-cm increase in height explained by nevus count was 8.03% in the NHS and 10.22% in the NHS2. LIMITATION Self-reported height and nevus count. Mole counts were limited to 1 arm or both legs. CONCLUSION Nevus count is an important explanatory factor for the excess risk of melanoma among taller white women.
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Affiliation(s)
- Xin Li
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Immaculata De Vivo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana; Department of Global Health, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
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Fore R, Hart JE, Choirat C, Thompson JW, Lynch K, Laden F, Chavarro JE, James P. Embedding Mobile Health Technology into the Nurses' Health Study 3 to Study Behavioral Risk Factors for Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:736-743. [PMID: 32098894 PMCID: PMC7171700 DOI: 10.1158/1055-9965.epi-19-1386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/11/2020] [Accepted: 02/18/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physical activity and sleep are behavioral risk factors for cancer that may be influenced by environmental exposures, including built and natural environments. However, many studies in this area are limited by residence-based exposure assessment and/or self-reported, time-aggregated measures of behavior. METHODS The Nurses' Health Study 3 (NHS3) Mobile Health Substudy is a pilot study of 500 participants in the prospective NHS3 cohort who use a smartphone application and a Fitbit for seven-day periods, four times over a year, to measure minute-level location, physical activity, heart rate, and sleep. RESULTS We have collected data on 435 participants, comprising over 6 million participant-minutes of heart rate, step, sleep, and location. Over 90% of participants had five days of ≥600 minutes of Fitbit wear-time in their first sampling week, and this percentage dropped to 70% for weeks 2 to 4. Over 819 sampling weeks, we observed an average of 7,581 minutes of heart rate and step data [interquartile range (IQR): 6,651-9,645] per participant-week, and >2 million minutes of sleep in over 5,700 sleep bouts. We have recorded location data for 5,237 unique participant-days, averaging 104 location observations per participant-day (IQR: 103-107). CONCLUSIONS This study describes a protocol to incorporate mobile health technology into a nationwide prospective cohort to measure high-resolution objective data on environment and behavior. IMPACT This project could provide translational insights into interventions for urban planning to optimize opportunities for physical activity and healthy sleep patterns to reduce cancer risk.See all articles in this CEBP Focus section, "Modernizing Population Science."
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Affiliation(s)
- Ruby Fore
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Jennifer W Thompson
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Kathleen Lynch
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jorge E Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Peter James
- Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Kawai K, VoPham T, Drucker A, Curhan SG, Curhan GC. Ultraviolet Radiation Exposure and the Risk of Herpes Zoster in Three Prospective Cohort Studies. Mayo Clin Proc 2020; 95:283-292. [PMID: 31883695 PMCID: PMC7007833 DOI: 10.1016/j.mayocp.2019.08.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 06/25/2019] [Accepted: 08/09/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine the association between ultraviolet radiation (UVR) exposure and the risk of herpes zoster (HZ) in 3 prospective cohorts. PATIENTS AND METHODS We included 205,756 participants from the Health Professionals Follow-up Study (HPFS; 1986-2008), Nurses' Health Study (NHS; 1996-2012), and Nurses' Health Study II (NHS II; 1991-2013). Ambient UVR exposure was based on updated geocoded address histories linked with a high-resolution spatiotemporal ultraviolet model. Incident HZ cases were identified by self-reported clinician diagnosis. Sunburn history and medical, lifestyle, and dietary factors were assessed using biennial questionnaires. Multivariable Cox proportional hazards models were used. RESULTS A total of 24,201 cases of HZ occurred during 3,626,131 person-years. Ambient UVR exposure was associated with a higher risk of HZ in men (HPFS: multivariable-adjusted hazard ratio [MVHR] comparing highest vs lowest quintiles, 1.14; 95% CI, 1.02-1.29; P=.03 for trend) but not in women (NHS: MVHR, 0.99; 95% CI, 0.93-1.05; NHS II: MVHR, 0.96; 95% CI, 0.90-1.03). A higher lifetime number of severe sunburns was associated with a higher risk of HZ in all cohorts (HPFS: MVHR for ≥10 sunburns vs none, 1.08; 95% CI, 0.96-1.20; P=.02 for trend; NHS: MVHR, 1.14; 95% CI, 1.05-1.22; P=.01 for trend; NHS II: MVHR, 1.13; 95% CI, 1.00-1.28; P<.001 for trend). CONCLUSION Ambient UVR exposure was associated with a higher risk of HZ in men but not in women. A history of severe sunburn was associated with a modest increased risk of HZ in men and women, possibly because of immunosuppression from overexposure to the sun.
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Affiliation(s)
- Kosuke Kawai
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | - Trang VoPham
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Aaron Drucker
- Department of Medicine, University of Toronto, Ontario, Canada; Women's College Research Institute, Toronto, Ontario, Canada; Department of Medicine, Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | - Sharon G Curhan
- Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA
| | - Gary C Curhan
- Harvard Medical School, Boston, MA; Department of Medicine, Renal Division, Brigham and Women's Hospital, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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Wei EX, Li X, Nan H. Having a first-degree relative with melanoma increases lifetime risk of melanoma, squamous cell carcinoma, and basal cell carcinoma. J Am Acad Dermatol 2019; 81:489-499. [DOI: 10.1016/j.jaad.2019.04.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/01/2019] [Accepted: 04/14/2019] [Indexed: 01/29/2023]
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Abstract
Supplemental Digital Content is available in the text. Background: Ultraviolet (UV) radiation exposure, the primary source of vitamin D for most people, may reduce breast cancer risk. To date, epidemiologic studies have shown inconsistent results. Methods: The Nurses’ Health Study II is a U.S. nationwide prospective cohort of female registered nurses. A UV exposure model was linked with geocoded residential address histories. Early-life UV exposure was estimated based on the state of residence at birth, age 15, and age 30. Self-reported breast cancer was confirmed from medical records. Time-varying Cox regression models adjusted for established breast cancer risk factors were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: From 1989 to 2013, 3,959 invasive breast cancer cases occurred among 112,447 participants. Higher UV exposure during adulthood was not associated with invasive breast cancer risk overall (adjusted HR comparing highest to lowest quintile = 1.00; 95% CI = 0.90, 1.11, P for trend = 0.64) or according to estrogen receptor (ER) status. There were suggestive inverse associations between ER− breast cancer and early-life UV exposure at birth (adjusted HR = 0.94; 95% CI = 0.88, 1.01 per interquartile range increase [15.7 mW/m2]), age 15 (adjusted HR = 0.96; 95% CI = 0.89, 1.04 per 18.0 mW/m2), and age 30 (adjusted HR = 0.90; 95% CI = 0.82, 1.00 per 27.7 mW/m2). Conclusions: Ambient UV exposure during adulthood was not associated with risk of invasive breast cancer overall or by ER status. However, we observed suggestive inverse associations between early-life UV exposure and ER− breast cancer risk.
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Bais AF, Bernhard G, McKenzie RL, Aucamp PJ, Young PJ, Ilyas M, Jöckel P, Deushi M. Ozone-climate interactions and effects on solar ultraviolet radiation. Photochem Photobiol Sci 2019; 18:602-640. [PMID: 30810565 DOI: 10.1039/c8pp90059k] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This report assesses the effects of stratospheric ozone depletion and anticipated ozone recovery on the intensity of ultraviolet (UV) radiation at the Earth's surface. Interactions between changes in ozone and changes in climate, as well as their effects on UV radiation, are also considered. These evaluations focus mainly on new knowledge gained from research conducted during the last four years. Furthermore, drivers of changes in UV radiation other than ozone are discussed and their relative importance is assessed. The most important of these factors, namely clouds, aerosols and surface reflectivity, are related to changes in climate, and some of their effects on short- and long-term variations of UV radiation have already been identified from measurements. Finally, projected future developments in stratospheric ozone, climate, and other factors affecting UV radiation have been used to estimate changes in solar UV radiation from the present to the end of the 21st century. New instruments and methods have been assessed with respect to their ability to provide useful and accurate information for monitoring solar UV radiation at the Earth's surface and for determining relevant exposures of humans. Evidence since the last assessment reconfirms that systematic and accurate long-term measurements of UV radiation and stratospheric ozone are essential for assessing the effectiveness of the Montreal Protocol and its Amendments and adjustments. Finally, we have assessed aspects of UV radiation related to biological effects and human health, as well as implications for UV radiation from possible solar radiation management (geoengineering) methods to mitigate climate change.
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Affiliation(s)
- A F Bais
- Laboratory of Atmospheric Physics, Aristotle University of Thessaloniki, Campus Box 149, 54124 Thessaloniki, Greece.
| | - G Bernhard
- Biospherical Instruments Inc., 5340 Riley Street, San Diego, California, USA
| | - R L McKenzie
- National Institute of Water & Atmospheric Research, NIWA Lauder, PB 50061 Omakau, Central Otago, New Zealand
| | - P J Aucamp
- Ptersa Environmental Management Consultants, PO Box 915751, Faerie Glen, 0043, South Africa
| | - P J Young
- Lancaster Environment Centre, Lancaster University, Lancaster, UK and Pentland Centre for Sustainability in Business, Lancaster University, Lancaster, UK
| | - M Ilyas
- School of Environmental Engineering, University Malaysia Perlis, Kangar, Malaysia
| | - P Jöckel
- Deutsches Zentrum fuer Luft- und Raumfahrt (DLR), Institut fuer Physik der Atmosphaere, Oberpfaffenhofen, Germany
| | - M Deushi
- Meteorological Research Institute (MRI), Tsukuba, Japan
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Wei EX, Li X, Nan H. Extremity nevus count is an independent risk factor for basal cell carcinoma and melanoma, but not squamous cell carcinoma. J Am Acad Dermatol 2019; 80:970-978. [PMID: 30713015 DOI: 10.1016/j.jaad.2018.09.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 08/04/2018] [Accepted: 09/11/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The presence of nevi portends an increased risk for melanoma. OBJECTIVE We sought to examine the association between extremity nevus count and the risk of melanoma and keratinocyte cancers. METHODS We evaluated prospective cohorts of 176,317 women (the Nurses' Health Study, 1986-2012 and the Nurses' Health Study 2, 1989-2013) and 32,383 men (Health Professionals Follow-up Study, 1986-2012). Information on nevus count (none, 1-5, 6-14, ≥15) on the extremity was collected at baseline. RESULTS There were 1704 incident cases of melanoma, 2296 incident cases of squamous cell carcinoma, and 30,457 incident cases of basal cell carcinoma, with a total of 4,655,043 person-years for melanoma and 4,267,708 person-years for keratinocyte cancers. The presence of an extremity nevus was associated with an increased risk of melanoma in all anatomic areas and increased risk of basal cell carcinoma (BCC). Individuals with ≥15 nevi had the highest risk of melanoma and BCC compared to those without any extremity nevi (melanoma hazard ratio 2.79 [95% confidence interval 2.04-3.83]; BCC HR 1.40 [95% confidence interval 1.32-1.49]). No significant association was observed for squamous cell carcinoma. LIMITATIONS Limitations of our study included self-reported nevus count and detection bias. CONCLUSIONS Extremity nevus count is a helpful clinical marker in risk-stratifying individuals for BCC and melanoma on all body sites.
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Affiliation(s)
- Erin X Wei
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Xin Li
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana; Indiana University Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana.
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Li WQ, Cho E, Wu S, Li S, Matthews NH, Qureshi AA. Host Characteristics and Risk of Incident Melanoma by Breslow Thickness. Cancer Epidemiol Biomarkers Prev 2019; 28:217-224. [PMID: 30341099 PMCID: PMC6324995 DOI: 10.1158/1055-9965.epi-18-0607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/10/2018] [Accepted: 10/04/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Several host characteristics, including pigmentary traits (hair color, sunburn susceptibility and tanning ability), number of common nevi (moles), and family history of melanoma, have been associated with risk of melanoma. METHODS We prospectively examined the associations between host characteristics and risk of incident melanoma by Breslow thickness (≤1 mm, thin melanoma; or >1 mm, "thicker melanoma") based on the Nurses' Health Study (NHS, n = 86,380 women), NHS II (n = 104,100 women), and Health Professionals Follow-up Study (HPFS, n = 46,934 men). RESULTS During 22-30 years' follow-up, a total of 1,813 incident melanoma cases were identified with information on Breslow thickness, 1,392 (76.8%) of which had thin melanoma. No significant differences were observed for thin and thicker melanoma in associations with hair color, sunburn susceptibility, and tanning ability. However, we found significant differences for the association with family history of melanoma, with a higher risk estimate for thicker melanoma [HR = 2.55; 95% confidence interval (CI): 1.91-3.42] than thin melanoma (HR = 1.59; 95% CI: 1.21-2.08; P heterogeneity = 0.02). Interestingly, women and men displayed differential associations between nevi count and risk of melanoma by Breslow thickness, with the association appearing stronger for thicker melanoma than thin melanoma in men (P heterogeneity = 0.01), but not in women. CONCLUSIONS Individuals with family history of melanoma may be more likely to develop thicker melanoma. Men with high number of common nevi may tend to develop thicker melanoma, which was not found for women. IMPACT The findings further stress the risk of thicker melanoma for individuals with a family history of melanoma and men with a high nevi count.
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Affiliation(s)
- Wen-Qing Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing, China.
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shaowei Wu
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Suyun Li
- School of Public Health, Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, China
| | - Natalie H Matthews
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Abrar A Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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VoPham T, Bertrand KA, Tamimi RM, Laden F, Hart JE. Ambient PM 2.5 air pollution exposure and hepatocellular carcinoma incidence in the United States. Cancer Causes Control 2018; 29:563-572. [PMID: 29696510 PMCID: PMC5940508 DOI: 10.1007/s10552-018-1036-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 04/18/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE To conduct the first epidemiologic study prospectively examining the association between particulate matter air pollution < 2.5 µm in diameter (PM2.5) exposure and hepatocellular carcinoma (HCC) risk in the U.S. METHODS Surveillance, Epidemiology, and End Results (SEER) provided information on HCC cases diagnosed between 2000 and 2014 from 16 population-based cancer registries across the U.S. Ambient PM2.5 exposure was estimated by linking the SEER county with a spatial PM2.5 model using a geographic information system. Poisson regression with robust variance estimation was used to calculate incidence rate ratios and 95% confidence intervals (CIs) for the association between ambient PM2.5 exposure per 10 µg/m3 increase and HCC risk adjusting for individual-level age at diagnosis, sex, race, year of diagnosis, SEER registry, and county-level information on health conditions, lifestyle, demographic, socioeconomic, and environmental factors. RESULTS Higher levels of ambient PM2.5 exposure were associated with a statistically significant increased risk for HCC (n = 56,245 cases; adjusted IRR per 10 µg/m3 increase = 1.26, 95% CI 1.08, 1.47; p < 0.01). CONCLUSIONS If confirmed in studies with individual-level PM2.5 exposure and risk factor information, these results suggest that ambient PM2.5 exposure may be a risk factor for HCC in the U.S.
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Affiliation(s)
- Trang VoPham
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
| | - Kimberly A Bertrand
- Slone Epidemiology Center at Boston University, 72 East Concord Street, Boston, MA, 02118, USA
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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VoPham T, Weaver MD, Vetter C, Hart JE, Tamimi RM, Laden F, Bertrand KA. Circadian Misalignment and Hepatocellular Carcinoma Incidence in the United States. Cancer Epidemiol Biomarkers Prev 2018; 27:719-727. [PMID: 29636342 DOI: 10.1158/1055-9965.epi-17-1052] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/31/2018] [Accepted: 04/05/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Circadian misalignment may increase the risk of developing hepatocellular carcinoma (HCC). The aim of this study was to examine the association between distance from time zone meridian, a proxy for circadian misalignment, and HCC risk in the United States adjusting for known HCC risk factors.Methods: Surveillance, Epidemiology, and End Results (SEER) provided information on 56,347 HCC cases diagnosed between 2000 and 2014 from 16 population-based cancer registries in the United States. Distance from time zone meridian was estimated using the location of each SEER county's Center of Population in a geographic information system. Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between distance from time zone meridian and HCC risk adjusting for individual-level age at diagnosis, sex, race/ethnicity, year of diagnosis, SEER registry, and county-level prevalence of health conditions, lifestyle factors, shift work occupation, socioeconomic status, and demographic and environmental factors.Results: A 5-degree increase in longitude moving east to west within a time zone was associated with a statistically significant increased risk for HCC (IRR, 1.07; 95% CI, 1.01-1.14, P = 0.03). A statistically significant positive association was observed among those <65 years old, while no association was observed among individuals ≥65 years old (Pfor interaction < 0.01).Conclusions: Circadian misalignment from residing in the western region of a time zone may impact hepatocarcinogenesis.Impact: Circadian misalignment may be an independent risk factor for HCC. Cancer Epidemiol Biomarkers Prev; 27(7); 719-27. ©2018 AACR.
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Affiliation(s)
- Trang VoPham
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. .,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts.,Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado, Boulder, Boulder, Colorado.,Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Rulla M Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Bais F, Luca RM, Bornman JF, Williamson CE, Sulzberger B, Austin AT, Wilson SR, Andrady AL, Bernhard G, McKenzie RL, Aucamp PJ, Madronich S, Neale RE, Yazar S, Young AR, de Gruijl FR, Norval M, Takizawa Y, Barnes PW, Robson TM, Robinson SA, Ballaré CL, Flint SD, Neale PJ, Hylander S, Rose KC, Wängberg SÅ, Häder DP, Worrest RC, Zepp RG, Paul ND, Cory RM, Solomon KR, Longstreth J, Pandey KK, Redhwi HH, Torikai A, Heikkilä AM. Environmental effects of ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2017. Photochem Photobiol Sci 2018; 17:127-179. [PMID: 29404558 PMCID: PMC6155474 DOI: 10.1039/c7pp90043k] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 12/11/2022]
Abstract
The Environmental Effects Assessment Panel (EEAP) is one of three Panels of experts that inform the Parties to the Montreal Protocol. The EEAP focuses on the effects of UV radiation on human health, terrestrial and aquatic ecosystems, air quality, and materials, as well as on the interactive effects of UV radiation and global climate change. When considering the effects of climate change, it has become clear that processes resulting in changes in stratospheric ozone are more complex than previously held. Because of the Montreal Protocol, there are now indications of the beginnings of a recovery of stratospheric ozone, although the time required to reach levels like those before the 1960s is still uncertain, particularly as the effects of stratospheric ozone on climate change and vice versa, are not yet fully understood. Some regions will likely receive enhanced levels of UV radiation, while other areas will likely experience a reduction in UV radiation as ozone- and climate-driven changes affect the amounts of UV radiation reaching the Earth's surface. Like the other Panels, the EEAP produces detailed Quadrennial Reports every four years; the most recent was published as a series of seven papers in 2015 (Photochem. Photobiol. Sci., 2015, 14, 1-184). In the years in between, the EEAP produces less detailed and shorter Update Reports of recent and relevant scientific findings. The most recent of these was for 2016 (Photochem. Photobiol. Sci., 2017, 16, 107-145). The present 2017 Update Report assesses some of the highlights and new insights about the interactive nature of the direct and indirect effects of UV radiation, atmospheric processes, and climate change. A full 2018 Quadrennial Assessment, will be made available in 2018/2019.
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Affiliation(s)
- F. Bais
- Aristotle Univ. of Thessaloniki, Laboratory of Atmospheric Physics, Thessaloniki, Greece
| | - R. M. Luca
- National Centre for Epidemiology and Population Health, Australian National Univ., Canberra, Australia
| | - J. F. Bornman
- Curtin Univ., Curtin Business School, Perth, Australia
| | | | - B. Sulzberger
- Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - A. T. Austin
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. R. Wilson
- School of Chemistry, Centre for Atmospheric Chemistry, Univ. of Wollongong, Wollongong, Australia
| | - A. L. Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State Univ., Raleigh, NC, USA
| | - G. Bernhard
- Biospherical Instruments Inc., San Diego, CA, USA
| | | | - P. J. Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - S. Madronich
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | - R. E. Neale
- Queensland Institute of Medical Research, Royal Brisbane Hospital, Brisbane, Australia
| | - S. Yazar
- Univ. of Western Australia, Centre for Ophthalmology and Visual Science, Lions Eye Institute, Perth, Australia
| | | | - F. R. de Gruijl
- Department of Dermatology, Leiden Univ. Medical Centre, Leiden, The Netherlands
| | - M. Norval
- Univ. of Edinburgh Medical School, UK
| | - Y. Takizawa
- Akita Univ. School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - P. W. Barnes
- Department of Biological Sciences and Environment Program, Loyola Univ., New Orleans, USA
| | - T. M. Robson
- Research Programme in Organismal and Evolutionary Biology, Viikki Plant Science Centre, Univ. of Helsinki, Finland
| | - S. A. Robinson
- Centre for Sustainable Ecosystem Solutions, School of Biological Sciences, Univ. of Wollongong, Wollongong, NSW 2522, Australia
| | - C. L. Ballaré
- Univ. of Buenos Aires, Faculty of Agronomy and IFEVA-CONICET, Buenos Aires, Argentina
| | - S. D. Flint
- Dept of Forest, Rangeland and Fire Sciences, Univ. of Idaho, Moscow, ID, USA
| | - P. J. Neale
- Smithsonian Environmental Research Center, Edgewater, Maryland, USA
| | - S. Hylander
- Centre for Ecology and Evolution in Microbial model Systems, Linnaeus Univ., Kalmar, Sweden
| | - K. C. Rose
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - S.-Å. Wängberg
- Dept Marine Sciences, Univ. of Gothenburg, Göteborg, Sweden
| | - D.-P. Häder
- Friedrich-Alexander Univ. Erlangen-Nürnberg, Dept of Biology, Möhrendorf, Germany
| | - R. C. Worrest
- CIESIN, Columbia Univ., New Hartford, Connecticut, USA
| | - R. G. Zepp
- United States Environmental Protection Agency, Athens, Georgia, USA
| | - N. D. Paul
- Lanter Environment Centre, Lanter Univ., LA1 4YQ, UK
| | - R. M. Cory
- Earth and Environmental Sciences, Univ. of Michigan, Ann Arbor, MI, USA
| | - K. R. Solomon
- Centre for Toxicology, School of Environmental Sciences, Univ. of Guelph, Guelph, ON, Canada
| | - J. Longstreth
- The Institute for Global Risk Research, Bethesda, MD, USA
| | - K. K. Pandey
- Institute of Wood Science and Technology, Bengaluru, India
| | - H. H. Redhwi
- Chemical Engineering Dept, King Fahd Univ. of Petroleum and Minerals, Dhahran, Saudi Arabia
| | - A. Torikai
- Materials Life Society of Japan, Kayabacho Chuo-ku, Tokyo, Japan
| | - A. M. Heikkilä
- Finnish Meteorological Institute R&D/Climate Research, Helsinki, Finland
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VoPham T, Bertrand KA, Yuan JM, Tamimi RM, Hart JE, Laden F. Ambient ultraviolet radiation exposure and hepatocellular carcinoma incidence in the United States. Environ Health 2017; 16:89. [PMID: 28821245 PMCID: PMC5562984 DOI: 10.1186/s12940-017-0299-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/14/2017] [Indexed: 05/07/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC), the most commonly occurring type of primary liver cancer, has been increasing in incidence worldwide. Vitamin D, acquired from sunlight exposure, diet, and dietary supplements, has been hypothesized to impact hepatocarcinogenesis. However, previous epidemiologic studies examining the associations between dietary and serum vitamin D reported mixed results. The purpose of this study was to examine the association between ambient ultraviolet (UV) radiation exposure and HCC risk in the U.S. METHODS The Surveillance, Epidemiology, and End Results (SEER) database provided information on HCC cases diagnosed between 2000 and 2014 from 16 population-based cancer registries across the U.S. Ambient UV exposure was estimated by linking the SEER county with a spatiotemporal UV exposure model using a geographic information system. Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between ambient UV exposure per interquartile range (IQR) increase (32.4 mW/m2) and HCC risk adjusting for age at diagnosis, sex, race, year of diagnosis, SEER registry, and county-level information on prevalence of health conditions, lifestyle, socioeconomic, and environmental factors. RESULTS Higher levels of ambient UV exposure were associated with statistically significant lower HCC risk (n = 56,245 cases; adjusted IRR per IQR increase: 0.83, 95% CI 0.77, 0.90; p < 0.01). A statistically significant inverse association between ambient UV and HCC risk was observed among males (p for interaction = 0.01) and whites (p for interaction = 0.01). CONCLUSIONS Higher ambient UV exposure was associated with a decreased risk of HCC in the U.S. UV exposure may be a potential modifiable risk factor for HCC that should be explored in future research.
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Affiliation(s)
- Trang VoPham
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | | | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | - Rulla M. Tamimi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Francine Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA USA
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