Use of Tanning Beds and Incidence of Skin Cancer
Use of Tanning Beds and Incidence of Skin Cancer
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DOI：
10.1200/jco.2011.39.3652
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发表时间：
2012-05-10
影响因子：
45.3
通讯作者：
Han, Jiali
中科院分区：
文献类型：
--
作者：
Zhang, Mingfeng;Qureshi, Abrar A.;Han, Jiali
目的：我们试图评估在青少年和年轻人中使用日光浴床对皮肤癌的风险影响。我们还希望确定是否存在明显的剂量-反应关系。患者和方法我们观察了73，494名女护士20年（从1989年到2009年），在美国的一个大型和特征明确的队列中，研究了在高中/大学期间和25岁到35岁之间使用晒黑床的频率是否与基底细胞癌（BCC）的风险相关，鳞状细胞癌（SCC）和黑色素瘤。我们使用考克斯比例风险模型，并仔细调整主机的危险因素，紫外线指数的居住，并在一个年轻的age.ResultsDuring随访，5,506护士被诊断为基底细胞癌，403与SCC，349与黑色素瘤。在这两个时期，每年使用日光浴床4次的增量增加的皮肤癌的多变量调整风险比（HR）为1.15（95% CI，1.11至1.19; P <0.001）BCC，1.15（95% CI，1.01至1.31; P = 0.03）SCC，1.11（95% CI，0.97至1.27; P = 0.13）黑素瘤。与25岁至35岁使用日光浴床相比，我们发现高中/大学期间使用BCC的风险显著更高（在高中/大学期间，每年使用超过6次与不使用相比的多变量调整HR为1.73，在25至35岁时为1.28;异质性P <0.001）。结论我们的数据提供了证据，证明晒黑床的使用与皮肤癌风险之间存在剂量-反应关系，尤其是BCC，并且暴露时年龄较小的患者的相关性更强。
PurposeWe sought to evaluate the risk effect of tanning bed use on skin cancers among teenage and young adults. We also expected to determine whether a dose-response relationship was evident.Patients and MethodsWe observed 73,494 female nurses for 20 years (from 1989 to 2009) in a large and well-characterized cohort in the United States and investigated whether frequency of tanning bed use during high school/college and at ages 25 to 35 years were associated with a risk of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. We used Cox proportional hazards models and carefully adjusted for host risk factors, ultraviolet index of residence, and sun exposure behaviors at a young age.ResultsDuring follow-up, 5,506 nurses were diagnosed with BCC, 403 with SCC, and 349 with melanoma. The multivariable-adjusted hazard ratio (HR) of skin cancer for an incremental increase in use of tanning beds of four times per year during both periods was 1.15 (95% CI, 1.11 to 1.19; P < .001) for BCC, 1.15 (95% CI, 1.01 to 1.31; P = .03) for SCC, and 1.11 (95% CI, 0.97 to 1.27; P = .13) for melanoma. Compared with tanning bed use at ages 25 to 35 years, we found a significantly higher risk of BCC for use during high school/college (multivariable-adjusted HR for use more than six times per year compared with no use was 1.73 during high school/college v 1.28 at ages 25 to 35 years; P for heterogeneity < .001).ConclusionOur data provide evidence for a dose-response relationship between tanning bed use and the risk of skin cancers, especially BCC, and the association is stronger for patients with a younger age at exposure.