Prospective study of ultraviolet radiation exposure and risk of cancer in the United States

Abstract

Ecologic studies have reported that solar ultraviolet radiation (UVR) exposure is associated with cancer, but little evidence is available from prospective studies. We aimed to assess the association between an objective measure of ambient UVR exposure and risk of total and site-specific cancer in a large, regionally diverse cohort (450,934 white, non-Hispanic subjects (50-71 years old) in the prospective NIH-AARP Diet and Health Study) after accounting for individual-level confounding risk factors. Estimated erythemal UVR exposure from satellite Total Ozone Mapping Spectrometer (TOMS) data from NASA was linked to the U.S. Census Bureau 2000 census tract (centroid) of baseline residence for each subject. We used Cox proportional hazards models adjusted for multiple potential confounders to estimate hazard ratios (HR) and 95% confidence intervals (CI) for quartiles of UVR exposure. Restricted cubic splines examined non-linear relationships. Over 9 years of follow-up, UVR exposure was inversely associated with total cancer risk (N=75,917; highest vs. lowest quartile, HR=0.97 (0.95, 0.99), p-trend<0.001). In site-specific cancer analyses, UVR exposure was associated with increased melanoma risk (highest vs. lowest quartile, HR=1.22 (1.13, 1.32), p-trend<0.001) and decreased risk of Non-Hodgkin’s lymphoma (HR=0.82 (0.74, 0.92)) and colon (HR=0.88 (0.82, 0.96)), squamous cell lung (HR=0.86 (0.75, 0.98)), pleural (HR=0.57 (0.38, 0.84)), prostate (HR=0.91 (0.88, 0.95)), kidney (HR=0.83 (0.73, 0.94)), and bladder (HR=0.88 (0.81, 0.96)) cancers (all p-trend<0.05). We also found non-linear associations for some cancer sites, including the thyroid and pancreas. Our results add to mounting evidence for the influential role of UVR exposure on cancer.

Sun Exposure and the Risk of Prostate Cancer in the Singapore Prostate Cancer Study: a Case-control Study

“…In the last decade, there were reports on the likely protective effect of sun exposure for prostate cancer, however these reports were not consistent (Bodiwala et al, 2003;John et al, 2005;Gilbert et al, 2009;Nair-Shalliker et al, 2011;Lin et al, 2012). Hanchette and Schwartz reported the association between sun exposure and risk of prostate cancer.…”

“…They showed an inverse relationship between sun exposure and mortality rate from prostate cancer among White men in 3,073 counties in the United States of America (Hanchette et al, 1992). Since then there have been case-control, cohort and ecological studies that reported on the protective nature of sun exposure and prostate cancer (Gilbert et al, 2009;Gupta et al, 2009;Lin et al, 2012). Early reviews on this subject seem to suggest the protective nature of sun exposure to prostate cancer (Moon et al, 2005), other reports only suggested a weak protective effect.…”

Association between Ambient Ultraviolet Radiation and Risk of Epithelial Ovarian Cancer

“…Nevertheless, a recent cohort study that used the TOMS database to estimate ambient UVR found no association between ambient UVR and the risk of ovarian cancer (10). Notably, this study examined only the relationship with ambient UVR at the point of study entry, a maximum of 9 years before cancer diagnosis, unlike our study which considered the effect of total lifetime exposure.…”

“…One case-control study from the United States found that the level of ambient UVR estimated from the state of residence recorded on the death certificate was inversely associated with mortality from ovarian cancer (9), but there was no association with sun exposure estimated from usual occupation. Recently, a longitudinal study also in the United States showed no association between residential ambient UVR and risk of ovarian cancer (10).…”

Vitamin D in Blood and Risk of Prostate Cancer: Lessons from the Selenium and Vitamin E Cancer Prevention Trial and the Prostate Cancer Prevention Trial

“…Numerous ecologic studies replicated the inverse correlation of prostate cancer rates with sunlight (9-11). Analytic studies support a protective effect of sunlight exposure in individual men, including an effect for exposure during early life (12)(13)(14). However, results from serologic studies of 25-OHD and prostate cancer risk have been inconsistent, with articles reporting negative, null, and positive associations (for review see ref.…”