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Photochem Photobiol. 2017 Nov;93(6):1483-1491. doi: 10.1111/php.12807. Epub 2017 Sep 4.

Early Life UV and Risk of Basal and Squamous Cell Carcinoma in New South Wales, Australia.

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Sydney Medical School, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia.
School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
Sax Institute, Sydney, NSW, Australia.
South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.
Department of Environment and Geography, Faculty of Science, Formerly Geographic Information Systems, Macquarie University, Sydney, NSW, Australia.
Molecular Diagnostics of Oncogenic Infections Division, German Cancer Research Center (DKFZ), Heidelberg, Germany.
School of Population Health, University of Western Australia, Perth, WA, Australia.


Sun exposure is the main cause of squamous (SCC) and basal cell carcinoma (BCC) although pattern and amount differ by cancer type, and sun sensitivity is the major host risk factor. Our study investigated risk factors and residential ambient UV in a population-based sample of Australian 45 and Up Study participants: 916 BCC cases, 433 SCC cases, 1224 controls. Unconditional logistic regression models adjusting for key covariates demonstrated 60% increased BCC risk and two-fold increased SCC risk with sun sensitivity, and three- and four-fold increased risk, respectively, with solar keratoses. BCC but not SCC risk increased with higher early-life residential UV in all participants (odds ratio (OR) = 1.54; 95% CI 1.22-1.96 for intermediate; OR = 1.31; 95% CI 1.03-1.68 for high UV at birthplace) and similarly in Australian-born participants (P-values < 0.05). Risk of SCC but not BCC increased with long-term cumulative sun exposure assessed by self-reported outdoor work (OR 1.74, 95% CI 1.21-2.49). In conclusion, sun sensitivity is important for both cancers, early-life UV but not cumulative UV appears to increase BCC risk, the former an apparently novel finding, and SCC risk appears only to be related to long-term cumulative sun exposure.

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