Population-Based Approach to Skin Cancer Epidemiology

描述（由申请人提供）：阳光是皮肤癌的环境风险因素。人们已经做了大量的工作来描述和量化阳光照射。然而，对黑色素瘤、鳞状细胞癌和基底细胞癌的日晒风险估计差异很大。由于阳光照射的强度和剂量难以直接测量，大多数研究都向研究参与者询问有关阳光照射史的详细问题。几乎所有的问题都依赖于回忆几年前可能发生的低发病率事件。因此，这些措施受到系统回忆偏差和随机误分类。此外，到目前为止，主要采用病例对照研究设计，特别是用于评估黑色素瘤风险的研究。本提案所建议的工作将大大提高我们对皮肤癌流行病学的认识。我们有一个独特的机会在钱宁实验室的环境中测试我们的假设，那里现有的纵向数据集是基于护士健康研究（NHS）的。已经为NHS收集了暴露于皮肤癌相关危险因素、确诊皮肤癌病例和地理编码（即地图）地址的数据。该建议的导师是皮肤病学和流行病学方面经验丰富的调查人员，熟悉NHS队列。他们也有相当多的

DESCRIPTION (provided by applicant): Sunlight is an environmental risk factor for skin cancer. A great deal of work has been done to characterize and quantify sun exposure. However, sun exposure risk estimates for melanoma, squamous cell carcinoma and basal cell carcinoma vary widely. As the magnitude and dose of sun exposure are difficult to measure directly, majority of studies ask study participants detailed questions about sun exposure history. Almost all the questions rely on recalling low morbidity events that may have occurred several years ago. Hence, these measures are subject to systematic recall bias and random misclassification. Also, mainly case-control study designs have been used thus far, particularly for studies that have evaluated risk for melanoma. Work suggested in this proposal will significantly improve our understanding of skin cancer epidemiology. We have a unique opportunity to test our hypotheses in the environment at the Channing Laboratory where existing longitudinal datasets are based such as the Nurses' Health Study (NHS). Data on exposure to skin cancer-related risk factors, confirmed skin cancer cases and geocoded (i.e. mapped) addresses has already been gathered for NHS. The mentors for this proposal are experienced investigators in dermatology and epidemiology and are familiar with the NHS cohort. They also have considerable experience with the epidemiology of skin cancer and participate in projects that are part of the SPORE for Skin Cancer. Combined with this research environment, experienced mentors and training plan suggested in this proposal, we are in a unique position to accomplish the following specific aims: 1. To examine the relationship between history of sun exposure and basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma (MM) in NHS. 2. To evaluate the relationship between exposure to ultraviolet radiation (UV) flux in the US (via Robertson Berger meters) and BCC, SCC and MM development (geocoded) in NHS. 3. To assess the relationship between history of sun exposure (Aim 1) and UV radiation (Aim 2) and multiple primary BCCs, SCCs and MMs in NHS.