Interaction of Area-Level Socioeconomic Status and UV Radiation on Melanoma Occurrence in California
Interaction of Area-Level Socioeconomic Status and UV Radiation on Melanoma Occurrence in California
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DOI：
10.1158/1055-9965.epi-10-0692
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发表时间：
2010-11-01
影响因子：
3.8
通讯作者：
Cockburn, Myles G.
中科院分区：
文献类型：
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作者：
Clarke, Christina A.;Moy, Lisa M.;Cockburn, Myles G.
背景资料：黑色素瘤发病率与社会经济地位（SES）和低纬度以及环境紫外线辐射（UVR）的其他措施密切相关。然而，因为高SES人群可能会共处在高紫外线辐射的地区，我们评估了他们的联合影响黑色素瘤的发生，以更好地为黑色素瘤教育和screening.Methods的目标亚群：我们获得了从加州癌症登记信息关于23,564例非西班牙裔白色居民之间的侵袭性皮肤黑色素瘤的事件1月1日，1998年，2002年12月31日。我们根据诊断时的居住地对每个病例进行地理编码，并将先前测试的SES和平均年UVR的邻里测量值联系起来，以计算年龄调整后的发病率，率比和相应的95%置信区间。Poisson回归被用来计算多变量调整率ratios.Results：紫外线辐射是显着的，正相关的黑色素瘤的发病率只有生活在前40%的加州社区排名SES的人。生活在SES和UVR最高的社区的人比生活在SES和UVR最低的社区的人患黑色素瘤的几率高60（率比，1.60; 95%可信区间，1.02-2.51）。结论：我们的研究结果表明，紫外线辐射和社会经济地位相互作用，影响黑色素瘤的发生，并表明黑色素瘤发病率的社会经济梯度不能完全由紫外线辐射解释。癌症预防和早期发现教育工作应针对高紫外线辐射暴露地区的高社会经济地位群体。在未来的研究中，SES和UVR的背景测量应被视为黑色素瘤发生的重要决定因素。癌症流行病学生物标志物Prev; 19（11）; 2727-33。（C）2010年AACR。
Background: Melanoma incidence has been correlated strongly and positively with both socioeconomic status (SES) and lower latitude and other measures of ambient UV radiation (UVR). However, because high-SES populations may be colocated in areas of high UVR, we assessed their joint influences on melanoma occurrence to better target subpopulations for melanoma education and screening.Methods: We obtained from the California Cancer Registry information regarding 23,564 incident cases of invasive cutaneous melanoma among non-Hispanic white residents between January 1, 1998, and December 31, 2002. We geocoded each case based on residence at diagnosis and linked previously tested neighborhood measures of SES and average annual UVR to calculate age-adjusted incidence rates, rate ratios, and the corresponding 95% confidence intervals. Poisson regression was used to calculate multi-variately adjusted rate ratios.Results: UVR was significantly and positively associated with melanoma incidence only among persons living in the top 40% of California neighborhoods ranked by SES. People in neighborhoods of the highest SES and UVR categories had 60% higher rates of melanoma than those from neighborhoods in the lowest categories (rate ratio, 1.60; 95% confidence interval, 1.02-2.51).Conclusion: Our findings indicate that UVR and SES interact to influence melanoma occurrence and suggest that socioeconomic gradients in melanoma incidence are not explained entirely by UVR.Impact: Cancer prevention and early detection educational efforts should be targeted to high-SES groups in areas of high UVR exposure. Contextual measures of both SES and UVR should be considered important determinants of melanoma occurrence in future studies. Cancer Epidemiol Biomarkers Prev; 19(11); 2727-33. (C)2010 AACR.