Measures of Cumulative Exposure from a Standardized Sun Exposure History Questionnaire: A Comparison with Histologic Assessment of Solar Skin Damage

Abstract

Ultraviolet radiation exposure is the dominant environmental determinant of all major forms of skin cancer; however, the nature of the association is incompletely understood. Existing instruments to capture sun exposure history tend to yield reproducible results, but the validity of these responses is unknown. To address this question, the authors examined the relation between responses to a standardized sun exposure instrument and histologic evidence of actinic damage in a population-based study of keratinocyte cancers from New Hampshire diagnosed from July 1, 1997, through March 31, 2000. A single study dermatopathologist histologically reviewed the adjacent skin of 925 skin cancer biopsies for the presence of solar keratoses and the extent of solar elastosis. The authors compared these measures with responses to a personal interview on history of sunburns, sunbathing, and time spent outdoors. Focusing on site-specific exposure, they found variables that estimated cumulative exposure related to histologic evidence of actinic damage. In contrast, measures of acute/intermittent exposure were generally unrelated to solar damage histologically. Findings suggest that cumulative, but not intermittent, measures of sun exposure derived from a personal interview appear to reflect a person's exposure history based on histologic evidence.

Antibody responses to 26 skin human papillomavirus types in the Netherlands, Italy and Australia

“…UV light is a ubiquitous exposure, which poses challenges for epidemiological inquiry (Karagas et al, 2007). The analysis of UV exposure based on the reported number of hours spent outside has limitations, e.g.…”

Early-Onset Basal Cell Carcinoma and Indoor Tanning: A Population-Based Study

“…Questions included detailed sociodemographic and skin cancer risk factors including skin reaction to the sun after first exposure in the summer (ie, tendency to sunburn). To estimate sun exposure, we used a standardized questionnaire adapted from an earlier study 28 and tested for its validity in our population 27 to elicit information about amount of time spent outdoors on work days and nonwork days (both in the summer and other times of the year) and history of painful and blistering sunburns. For diagnoses beginning with July 1998, we requested a diagnostic slide of the original tumor.…”

Early-Onset Basal Cell Carcinoma and Indoor Tanning: A Population-Based Study

“…[24][25][26][27] BCC cases diagnosed from July 1993 to June 1995 and July 1997 to March 2000 were randomly selected (for efficiency) within strata defined by anatomic site, age, and gender to ensure representation of the entire group of BCC diagnoses. 26 …”

“…), who determined the severity of solar elastosis in the skin adjacent to each tumor (graded as absent, minimal, moderate, or severe). 27 Solar elastosis was categorized as mild if single, scattered, blue-gray elastotic fibers were identified in the papillary dermis; moderate if clumps of elastotic fibers with intervening normal papillary dermis were present; and severe if replacement of the papillary dermis by clumped elastotic fibers or amorphous masses of elastotic material was observed.…”