Skin Cancer and Arsenic Exposure

描述：皮肤黑色素瘤（CM）的发病率在美国比任何其他癌症都增长得快。紫外线（UV）辐射是CM发生的主要环境致病危险因素。然而，其他环境因素也可能很重要。先前的研究已经报道了砷和非黑色素瘤皮肤癌之间的联系。我们最近对CM病例和砷的研究发现，趾甲样本中砷的最高四分位数的调整优势比为2.1（趋势p值= 0.001）。我们建议通过更强的研究设计来验证这些发现。我们将进行一项以人群为基础的病例对照研究，研究CM事件和趾甲样本中检测到的砷含量。为了消除我们早期研究的偏差，我们将a）使用新诊断的病例而不是流行病例，B）使用诊断后1 - 9个月内收集的脚趾甲，c）使用非癌症对照组，d）使用中子活化分析（NAA），被认为是微量元素分析的金标准。爱荷华州居民的CM病例将通过爱荷华州癌症登记处进行半快速报告。基于人口的控制将使用爱荷华州选民登记文件，这是可比的爱荷华州人口普查数据。我们将邮寄给受试者一封介绍信、脚趾甲样本采集说明和小袋子。然后，我们将使用计算机辅助电话访谈（CATI）软件进行调查，以收集与居住历史（水源，阳光照射和职业）相关的复杂数据。这种格式将允许访问者收集居住历史，并探索有关每个住所潜在暴露的其他信息。我们将重点放在砷检测的NAA在趾甲样本的情况下，控制。此外，我们将评估该人群中CM的已知风险因素（包括自然和人工紫外线暴露、居住和职业史、阳光敏感性因素、皮肤癌家族史和防晒霜使用）。我们还将现有的饮用水中砷含量数据与受试者脚趾甲中的砷含量数据相关联。记录居住历史并将其与当前和历史水源联系起来，将使我们能够检查潜在砷暴露的时间长度，因为饮用水被认为是砷暴露的主要来源，并可能提供长期暴露的证据。收集砷暴露的生物标志物沿着调查对象关于已知的紫外线因素和他们的太阳敏感性将允许检查砷和CM之间的关联的重要的相互作用和潜在的混淆。

DESCRIPTION: The incidence of cutaneous melanoma (CM) is increasing faster than any other cancer in the United States. Ultraviolet (UV) radiation is the major environmental etiologic risk factor implicated in the development of CM. However, other environmental agents may also be important. Prior studies have reported associations between arsenic and non-melanoma skin cancers. Our recent study of CM cases and arsenic found an adjusted odds ratio of 2.1 for the highest quartile of arsenic in toenail samples (trend p-value=0.001). We propose to verify these findings through a stronger study design. We will conduct a population-based case-control study of incident CM cases and arsenic content detected in toenail samples. To eliminate biases of our earlier study, we will a) use newly diagnosed cases rather than prevalent cases, b) use toenails collected within 1-9 months of diagnosis, c) use a non-cancer control group, and d) use neutron activation analysis (NAA), considered the gold standard in trace element analyses. CM cases in Iowa residents will be semi-rapid reported through the Iowa Cancer Registry. Population-based controls will be identified using the Iowa Voter Registration file, which is comparable to the Iowa Census data. We will mail subjects an introductory letter, instructions for the toenail sample collection and small baggie. We will then conduct the survey using computer assisted telephone interviewing (CATI) software in order to collect complex data related to residential histories (water source, sun exposure, and occupations). This format will allow interviewers to collect a residential history and probe for additional information about potential exposures at each residence. We will focus on arsenic detected by NAA in toenail samples from cases and controls. Additionally, we will assess known risk factors for CM in this population (including natural and artificial UV exposure, residential and occupational histories, sun sensitivity factors, family history of skin cancer, and sunscreen use). We will also correlate available data on arsenic levels in current drinking water to arsenic in subjects' toenails. Recording residential histories and relating them to current and historical water sources will allow us to examine the length of the potential arsenic exposure, since drinking water is believed to be the main source of arsenic exposure and may provide evidence of long term exposure. Collecting biomarkers of arsenic exposure along with surveying subjects about known UV factors and their sun sensitivity will allow for the examination of important interactions and potential confounding of the association between arsenic and CM.