Five or More Blistering Sunburns in Early Life May Raise Melanoma Risk by 80%
According to a large study of Caucasian women investigating chronic sun exposure over long durations in adulthood and sun exposure in early life, those who had at least five blistering sunburns when they were 15 to 20 years old had a 68% increased risk for basal cell carcinoma and squamous cell carcinoma, and an 80% increased risk for melanoma. Those participants who were exposed to the highest amounts of cumulative ultraviolet (UV) radiation in adulthood had no increased risk for melanoma, but had a 2.35-fold increased risk for developing basal cell carcinoma and a 2.53-fold increased risk for developing squamous cell carcinoma. The study by Wu et al is published in Cancer Epidemiology, Biomarkers & Prevention.
Study Methods and Findings
Researchers followed 108,916 Caucasian women enrolled in the Nurses’ Health Study II (NHS II) over 20 years. The women were between the ages of 25 and 42 and resided in 14 states at enrollment. At registration, the participants responded to a baseline questionnaire about their medical histories and potential risk factors for skin cancers, including number of moles on legs, number of blistering sunburns between the ages of 15 and 20, and family history of melanoma. Updated health information related to skin cancer risk, including family history, hair color, tanning bed use, smoking and alcohol consumption habits, and body mass index (BMI) was collected every 2 years.
The researchers took into account the duration participants spent residing at different locations in the United States during their follow-up to calculate their cumulative UV exposure, and then grouped the participants under three categories of UV exposure: low, medium, and high baseline annual UV flux. They found that about 24% of the participants had experienced painful blisters as a child or adolescent, about 10% had more than five blistering sunburns between the ages of 15 and 20, and about 24% had used tanning beds.
Of the study participants, 6,955 were diagnosed with basal cell carcinoma, 880 with squamous cell carcinoma of the skin, and 779 were diagnosed with melanoma. Of those with melanoma, 445 had invasive cancer.
Host-Risk Factors
Participants with red hair and higher sunburn reaction susceptibility as a child/adolescent were more likely to develop skin cancer of any type. Family history of melanoma and number of moles on legs were most strongly associated with melanoma risk, followed by basal cell carcinoma risk. Higher BMI was associated with decreased risks of basal cell carcinoma and squamous cell carcinoma, and higher alcohol intake was associated with increased risk of basal cell carcinoma and melanoma. Menopausal status had a marginal association with basal cell carcinoma risk.
“Pattern of sun exposure was not uniformly associated with the risk for all the three main skin cancers we see in the United States, suggesting that there are some differences in the pathophysiology of these skin cancers,” said Abrar A. Qureshi, MD, MPH, a coauthor of the study and Professor and Chair of the Department of Dermatology at The Warren Alpert Medical School of Brown University and Rhode Island Hospital in Providence, in a statement. “An individual’s risk of developing skin cancer depends on both host and environmental risk factors. Persons with high host-risk traits, such as red hair color, higher number of moles, and high sunburn susceptibility, should pay more attention to avoid excessive sun exposure, especially early in life.”
These findings, concluded the researchers, may have potential implications for the prevention of skin cancers.
Dr. Qureshi is the corresponding author of the Cancer Epidemiology, Biomarkers & Prevention article.
The study was funded by the National Institutes of Health, and the Brigham and Women’s Hospital. Dr. Qureshi is a consultant/advisory board member of AbbVie, Amgen, the Centers for Disease Control and Prevention, Janssen, Merck, Novartis, and Pfizer. The other authors reported no potential conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
