The presence of certain types of human papillomavirus (HPV) is a known risk factor for the development of anogenital squamous cell carcinomas (SCCs). A similar association has been hypothesized for cutaneous SCCs, although, to our knowledge, no studies to date have combined sensitive HPV DNA detection techniques with epidemiologic data controlling for known risk factors to explore the association. We designed a case-control study examining HPV prevalence using highly sensitive PCR-detection assays in tissue samples from 85 immunocompetent patients with histologically confirmed SCCs and 95 age-matched individuals without a prior history of skin cancer. A standardized interview was administered to all study subjects to collect information pertaining to potential confounding variables. The overall detection rate of HPV DNA was high in case lesions (54%) and perilesions (50%) and in both sun-exposed normal tissue (59%) and non-sun-exposed normal tissue (49%) from controls. In comparing case tissue to control tissue, there was no differential detection of HPV DNA across various HPV species. However, HPV DNA from beta-papillomavirus species 2 was more likely to be identified in tumors than in adjacent healthy tissue among cases (paired analysis, odds ratio=4.0, confidence interval=1.3-12.0). The high prevalence of HPV DNA detected among controls suggests that HPV DNA is widely distributed among the general population. However, the differential detection of HPV beta-papillomavirus species in tumors among cases suggests that certain HPV types may be involved in the progression of cutaneous SCCs.

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A survey of benign melanocytic nevi (moles), suspected precursors or markers for melanoma, was conducted in Washington State among 717 randomly selected 18- to 50-year-old white adults who participated in a telephone interview in 1990-1991. Participants were questioned about constitutional factors, time spent in the sun, and severe sunburns over three time periods and were asked to count the raised nevi on both their arms. Logistic regression was used to examine the risk for 2+ nevi compared with none. An odds ratio (OR) of 2.0 (95% confidence interval (CI) 1.3-3.1) was seen for current freckling. Skin color, tendency to burn, and inability to tan were important risk factors but were not independent of each other. Individuals with a history of severe sunburns had an increased risk of nevi: OR = 1.9 (95% CI 0.9-3.9) for 3+ severe sunburns compared with none in the last 5 years; OR = 2.0 (95% CI 1.2-3.1) for 4+ severe teenage sunburns; and OR = 3.1 (95% CI 1.7-5.3) for 4+ severe childhood sunburns. Furthermore, childhood sunburns were related to nevi independently of sun sensitivity and teenage and recent sunburns: OR = 2.0 (95% CI 1.0-4.0) for 4+ severe sunburns. These data suggest that childhood sunburns are important in the etiology of nevi. This study supports prior studies of the relation between melanoma and early sun exposure.