A PROSPECTIVE-STUDY OF INCIDENT SQUAMOUS-CELL CARCINOMA OF THE SKIN IN THE NURSES HEALTH STUDY
A PROSPECTIVE-STUDY OF INCIDENT SQUAMOUS-CELL CARCINOMA OF THE SKIN IN THE NURSES HEALTH STUDY
复制标题
DOI：
10.1093/jnci/87.14.1061
复制
发表时间：
1995-07-19
期刊：
影响因子：
--
通讯作者：
HUNTER, DJ
中科院分区：
文献类型：
--
作者：
GRODSTEIN, F;SPEIZER, FE;HUNTER, DJ
背景资料：很少有流行病学研究可以量化与阳光照射和皮肤类型等相关因素相关的皮肤鳞状细胞癌（SCC）风险的大小，此外，一些研究发现吸烟与SCC之间存在关联，目的：我们前瞻性地研究了发生SCC的风险与表型的关系以及阳光照射的影响，以及吸烟和其他因素，在1976年基线时年龄在30-55岁的107900名主要是白色妇女的队列中进行了8年的随访，方法：从1976年开始，每两年向护士健康研究参与者发送一次关于病史和健康相关变量的问卷，关于宪法因素的资料（自然发色，儿童和青少年晒伤和晒黑的倾向，以及严重晒伤的终生次数），生活方式因素（夏季经常在户外活动和使用防晒霜），出生时和15岁和30岁时居住的国家，以及吸烟习惯通过问卷调查确定，共有197名首次发病的妇女，经组织学证实，对1982 ~ 1990年诊断的浸润性SCC进行多因素分析，采用比例风险模型计算相对危险度（RR）和相应的95%可信区间（CI），并对混杂因素进行调整。结果：居住在加州的妇女患SCC的危险性增加（RR = 1.8; 95% CI = 1.3-2.6）和佛罗里达（RR = 2.1; 95%CI = 1.1-3.9），与居住在东北部各州的妇女相比，出生时和15岁时居住在这些州的妇女的风险更高（加州的RR = 2.5; 95% CI = 1.4-4.4;佛罗里达的RR = 3.0; 95% CI = 0.7-1.2），红色（RR = 2.0; 95% CI = 1.1-3.7）和浅棕色（RR = 1.7; 95%CI = 1.2-2.4）与深棕色头发相比，头发颜色与SCC风险增加相关。在调整晒伤次数后，在儿童时期暴露在阳光下2小时或更长时间后容易烧伤的女性患SCC的风险略高于从未烧伤的女性（RR = 1.5; 95% CI = 0.9-2.5）烧伤和RR = 1.1;疼痛性烧伤的95% CI = 0.6-2.0），尽管严重烧伤的实际数量似乎是一个更重要的因素（RR = 2.4;六次或以上烧伤的95%CI = 1.5-4.0），最后，与从不吸烟者相比，目前吸烟者患SCC的风险增加了50%（RR = 1.5; 95% CI = 1.1-2.1），结论：应避免暴露在阳光下导致晒伤，特别是在早期年龄，以降低SCC事件的风险。
Background: Few epidemiologic studies are available that quantify the magnitude of the risk of squamous cell carcinoma (SCC) of the skin associated with sun exposure and related factors such as skin type, In addition, several studies have found an association between cigarette smoking and SCC, Purpose: We prospectively examined the risk of developing SCC in relation to phenotype and the effects of sun exposure, as well as to cigarette smoking and other factors, during 8 years of follow-up in a cohort of 107 900 predominantly white women aged 30-55 years at base line in 1976, Methods: Questionnaires regarding medical history and health-related variables were sent to Nurses' Health Study participants every 2 years, beginning in 1976, Information on constitutional factors (natural hair color, childhood and adolescent tendency to sunburn and tan, and lifetime number of severe sunburns), lifestyle factors (regular time spent outdoors in the summer and sunscreen use), the state lived in at birth and at ages 15 and 30 years, and cigarette smoking habits were ascertained by questionnaire, A total of 197 women with first-incident, histologically confirmed, invasive SCCs that were diagnosed from 1982 to 1990 were included in this analysis, Multivariate analysis using proportional hazards models was used to calculate the relative risks (RRs) and corresponding 95% confidence intervals (CIs), with adjustment for confounders, Results: The risk of SCC was increased in women living in California (RR = 1.8; 95% CI = 1.3-2.6) and Florida (RR = 2.1; 95% CI = 1.1-3.9) at base line, compared with those living in the northeastern states, This risk was higher for women living in those states at birth and at 15 years of age (RR = 2.5; 95% CI = 1.4-4.4 for California and RR = 3.0; 95% CI = 0.7-1.2 for Florida), Red (RR = 2.0; 95% CI = 1.1-3.7) and light brown (RR = 1.7; 95% CI = 1.2-2.4) hair colors were associated with an increased risk of SCC, compared with dark brown hair, After adjusting for the number of sunburns, women who tended to burn after 2 or more hours of sun exposure as children had a slightly higher risk of SCC than those who never burned (RR = 1.5; 95% CI = 0.9-2.5 for burn and RR = 1.1; 95% CI = 0.6-2.0 for painful burn), although the actual number of severe burns appeared to be a more important factor (RR = 2.4; 95% CI = 1.5-4.0 for six or more burns), Finally, current cigarette smokers showed a 50% increase in the risk of SCC compared with never smokers (RR = 1.5; 95% CI = 1.1-2.1), Conclusion: Exposure to the sun leading to sunburn, particularly at early ages, should be avoided to decrease the risk of incident SCC.