Basal cell carcinoma risk and solar UV exposure in occupationally relevant anatomic sites: do histological subtype, tumor localization and Fitzpatrick phototype play a role? A population-based case-control study

被引：22

作者：

Bauer, A. ^{[1
]}

Haufe, E. ^{[2
,3
]}

Heinrich, L. ^{[2
,3
]}

Seidler, A. ^{[4
,5
]}

Schulze, H. J. ^{[6
]}

Elsner, P. ^{[7
]}

Drexler, H. ^{[8
]}

Letzel, S. ^{[9
]}

John, S. M. ^{[10
,11
]}

Fartasch, M. ^{[12
]}

Bruening, T. ^{[12
]}

Dugas-Breit, S. ^{[6
]}

Gina, M. ^{[7
]}

Weistenhoefer, W. ^{[8
]}

Bachmann, K. ^{[13
]}

Bruhn, I. ^{[1
]}

Lang, B. M. ^{[14
]}

Brans, R. ^{[10
,11
]}

Allam, J. P. ^{[15
]}

Grobe, W. ^{[15
]}

Westerhausen, S. ^{[16
]}

Knuschke, P. ^{[17
]}

Wittlich, M. ^{[16
]}

Diepgen, T. L. ^{[13
]}

Schmitt, J. ^{[2
,3
]}

机构：

[1] Tech Univ Dresden, Univ AllergyCtr, Med Fac Carl Gustav Carus, Dept Dermatol, Fetscherstr 74, D-01307 Dresden, Germany

[2] Tech Univ Dresden, Univ Hosp, Ctr Evidence Based Healthcare, Dresden, Germany

[3] Tech Univ Dresden, Med Fac Carl Gustav Carus, Dresden, Germany

[4] Fac Med Carl Gustav Carus, Inst & Policlin Occupat & Social Med, Dresden, Germany

[5] Tech Univ Dresden, Inst & Outpatient Clin Occupat & Social Med, Med Fac Carl Gustav Carus, Dresden, Germany

[6] Special Clin Hornheide, Dept Dermatol Dermatol Radiotherapy & Dermatohist, Munster, Germany

[7] Univ Hosp Jena, Dept Dermatol, Jena, Germany

[8] Friedrich Alexander Univ Erlangen Nurnberg, Inst & Outpatient Clin Occupat Social & Environm, Erlangen, Germany

[9] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Inst Occupat Social & Environm Med, Mainz, Germany

[10] Univ Osnabruck, Dept Dermatol Environm Med & Hlth Theory, Osnabruck, Germany

[11] Univ Osnabruck, Inst Interdisciplinary Dermatol Prevent & Rehabil, Osnabruck, Germany

[12] Inst Ruhr Univ Bochum IPA, Inst Prevent & Occupat Med German Social Accid In, Bochum, Germany

[13] Heidelberg Univ, Dept Clin Social Med Occupat & Environm Dermatol, Heidelberg, Germany

[14] Johannes Gutenberg Univ Mainz, Univ Med Ctr, Dept Dermatol, Mainz, Germany

[15] Univ Bonn, Christine Kuhne Ctr Allergy Res & Educ, Dept Dermatol & Allergol, Bonn, Germany

[16] Inst Occupat Hlth & Safety German Social Accid In, Dept Radiat, St Augustin, Germany

[17] Tech Univ Dresden, Med Fac Carl Gustav Carus, Dept Dermatol, Expt Photobiol, Dresden, Germany

来源：

JOURNAL OF OCCUPATIONAL MEDICINE AND TOXICOLOGY | 2020年 / 15卷 / 01期

关键词：

Occupation; Solar UV exposure; Basal cell carcinoma; Outdoor work; Histological subtype; Localization; Fitzpatrick phototype; SKIN-CANCER; SUN EXPOSURE; AGE; WORKERS; PIGMENTARY; OUTDOOR; SEX;

D O I：

10.1186/s12995-020-00279-8

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background A two-fold risk increase to develop basal cell carcinoma was seen in outdoor workers exposed to high solar UV radiation compared to controls. However, there is an ongoing discussion whether histopathological subtype, tumor localization and Fitzpatrick phototype may influence the risk estimates. Objectives To evaluate the influence of histological subtype, tumor localization and Fitzpatrick phototype on the risk to develop basal cell carcinoma in highly UV-exposed cases and controls compared to those with moderate or low solar UV exposure. Methods Six hundred forty-three participants suffering from incident basal cell carcinoma in commonly sun-exposed anatomic sites (capillitium, face, lip, neck, dorsum of the hands, forearms outside, decollete) of a population-based, case-control, multicenter study performed from 2013 to 2015 in Germany were matched to controls without skin cancer. Multivariate logistic regression analysis was conducted stratified for histological subtype, phototype 1/2 and 3/4. Dose-response curves adjusted for age, age(2), sex, phototype and non-occupational UV exposure were calculated. Results Participants with high versus no (OR 2.08; 95% CI 1.24-3.50;p = 0.006) or versus moderate (OR 2.05; 95% CI 1.15-3.65;p = 0.015) occupational UV exposure showed a more than two-fold significantly increased risk to develop BCC in commonly UV-exposed body sites. Multivariate regression analysis did not show an influence of phototype or histological subtype on risk estimates. The restriction of the analysis to BCC cases in commonly sun-exposed body sites did not influence the risk estimates. The occupational UV dosage leading to a 2-fold increased basal cell carcinoma risk was 6126 standard erythema doses. Conclusion The risk to develop basal cell carcinoma in highly occupationally UV-exposed skin was doubled consistently, independent of histological subtype, tumor localization and Fitzpatrick phototype.

引用

页数：13

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