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BMC Dermatol. 2016 Jan 20;16:1. doi: 10.1186/s12895-016-0038-1.

Estimation of individual cumulative ultraviolet exposure using a geographically-adjusted, openly-accessible tool.

Author information

1
Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA. gefeizhu@stanford.edu.
2
Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA. iraber@stanford.edu.
3
Department of Computer Science, 353 Serra Mall, Stanford, CA, 94305, USA. sukolsak@stanford.edu.
4
Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA. shufeng@stanford.edu.
5
Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA. asli@stanford.edu.
6
Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA. cztan@stanford.edu.
7
Department of Dermatology, Stanford University School of Medicine, 450 Broadway St., Redwood City, CA, 94063, USA. alschang@stanford.edu.

Abstract

BACKGROUND:

Estimates of an individual's cumulative ultraviolet (UV) radiation exposure can be useful since ultraviolet radiation exposure increases skin cancer risk, but a comprehensive tool that is practical for use in the clinic does not currently exist. The objective of this study is to develop a geographically-adjusted tool to systematically estimate an individual's self-reported cumulative UV radiation exposure, investigate the association of these estimates with skin cancer diagnosis, and assess test reliability.

METHODS:

A 12-item online questionnaire from validated survey items for UV exposure and skin cancer was administered to online volunteers across the United States and results cross-referenced with UV radiation indices. Cumulative UV exposure scores (CUES) were calculated and correlated with personal history of skin cancer in a case-control design. Reliability was assessed in a separate convenience sample.

RESULTS:

1,118 responses were included in the overall sample; the mean age of respondents was 46 (standard deviation 15, range 18 - 81) and 150 (13 %) reported a history of skin cancer. In bivariate analysis of 1:2 age-matched cases (n = 149) and controls (n = 298), skin cancer cases were associated with (1) greater CUES prior to first skin cancer diagnosis than controls without skin cancer history (242,074 vs. 205,379, p = 0.003) and (2) less engagement in UV protective behaviors (p < 0.01). In a multivariate analysis of age-matched data, individuals with CUES in the lowest quartile were less likely to develop skin cancer compared to those in the highest quartile. In reliability testing among 19 volunteers, the 2-week intra-class correlation coefficient for CUES was 0.94. We have provided the programming code for this tool as well as the tool itself via open access.

CONCLUSIONS:

CUES is a useable and comprehensive tool to better estimate lifetime ultraviolet exposure, so that individuals with higher levels of exposure may be identified for counseling on photo-protective measures.

PMID:
26790927
PMCID:
PMC4721109
DOI:
10.1186/s12895-016-0038-1
[Indexed for MEDLINE]
Free PMC Article

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