Nonmelanoma skin cancer and risk for subsequent malignancy

被引：98

作者：

Chen, Jiping ^{[1
]}

Ruczinski, Ingo ^{[2
]}

Jorgensen, Timothy J. ^{[3
,5
]}

Yenokyan, Gayane ^{[3
]}

Yao, Yin ^{[3
]}

Alani, Rhoda ^{[6
,7
]}

Liegeois, Nanette J. ^{[6
]}

Hoffman, Sandra C. ^{[3
,8
]}

Hoffman-Bolton, Judith ^{[3
,8
]}

Strickland, Paul T. ^{[4
]}

Helzlsouer, Kathy J. ^{[3
,8
,9
]}

Alberg, Anthony J. ^{[3
,8
,10
]}

机构：

[1] Natl Canc Inst, Canc Prevent Div, Rockville, MD USA

[2] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Biostat, Baltimore, MD USA

[3] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[4] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Environm Hlth Sci, Baltimore, MD USA

[5] Georgetown Univ, Sch Med, Dept Radiat Med, Washington, DC USA

[6] Johns Hopkins Univ, Sch Med, Dept Dermatol, Baltimore, MD 21205 USA

[7] Johns Hopkins Univ, Sch Med, Dept Oncol, Baltimore, MD 21205 USA

[8] George W Comstock Ctr Publ Hlth Res & Prevent, Washington Cty, MD USA

[9] Mercy Med Ctr, Baltimore, MD USA

[10] Med Univ S Carolina, Hollings Canc Ctr, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29425 USA

来源：

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE | 2008年 / 100卷 / 17期

关键词：

D O I：

10.1093/jnci/djn260

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Individuals with a personal history of nonmelanoma skin cancer (NMSC) may have an increased risk of subsequent noncutaneous malignancies. To test this hypothesis, we carried out a community-based, prospective cohort study. Methods In the CLUE (Give Us a Clue to Cancer and Heart Disease) II cohort, which was established in Washington County, MD, in 1989, the risk of new malignancies was compared among individuals with (n = 769) and without (n = 18 405) a personal history of NMSC (total n = 19 174) during a 16-year follow-up period. Pathologically confirmed NMSC (and other malignancies) were ascertained from the Washington County Cancer Registry. Cox regression analysis with time-dependent covariates was used to determine the hazard ratios (presented as multivariable-adjusted relative risks [RRs]) and 95% confidence intervals (CIs) of second primary malignancies associated with a previously confirmed NMSC diagnosis. All statistical tests were two-sided. Results The crude incidence rate (per 10 000 person-years) of subsequent cancers other than NMSC among participants with a positive personal history of NMSC was 293.5 and with a negative history was 77.8. Compared with persons with no personal history of NMSC, those with such a history had a statistically significantly increased risk of being diagnosed with a subsequent cancer other than NMSC (RR = 1.99, 95% CI = 1.70 to 2.33) after adjusting for age, sex, body mass index, smoking status, and educational level. The association was observed for both basal cell carcinoma (multivariable-adjusted RR = 2.03, 95% CI = 1.70 to 2.42) and squamous cell carcinoma (multivariable-adjusted RR = 1.97, 95% CI = 1.50 to 2.59) of the skin. NMSC was a statistically significantly stronger cancer risk factor in younger age groups than in older age groups (P for interaction = .022). Conclusions This community-based, prospective cohort study provides evidence for an association between an NMSC diagnosis and an increased risk of subsequent cancer, even after adjusting for individual-level risk factors.

引用

页码：1215 / 1222

页数：8

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