Risk factors for actinic cheilitis: A meta-analysis

Abstract

Background. Actinic cheilitis (AC) is a potentially malignant disorder characterized by chronic lip inflammation, especially the lower lip, associated with accumulative exposure to solar radiation. The present study aimed to assess the possible risk factors related to AC. Methods. A search for studies on AC risk factors was conducted in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Google Scholar. For dichotomous outcomes, the estimates of the effects of intervention were expressed as odds ratios (ORs) using Mantel-Haenszel (M-H) method, and for continuous outcomes, the estimates of the effects of intervention were expressed as mean difference (MD) using the inverse variance (IV) method, both with 95% confidence intervals. Results. Twelve studies were considered in this meta-analysis. The factors from the highest to lowest risk of AC were having a low skin phototype (OR: 3.30), age >50 years (OR: 3.01), having high sun exposure, cumulative throughout life (OR: 2.13) as daily (OR: 2.00), being male (OR: 1.78), and being a drinker (OR: 1.56) or smoker (OR: 1.32). However, the use of sunscreen creams and caps/hats to protect against the sun were factors with no significant influence on the AC risk. Conclusion. Chronic sun exposure in subjects with low skin phototypes is the main risk factor for AC.

Actinic Cheilitis: Epidemiological Study Among Rural Workers

“…as the number of hours of sun exposure increases, that is, the tissue damage induced by sun exposure is cumulative, showing the chronicity of the lip lesion. 11,12,13 Furthermore, the literature corroborates differences regarding skin phototype. Thus, it is possible to notice that the lower the skin phototype (Fitzpatrick I-II), the lower the concentration of melanin at the level of the basal layer of keratinocytes, the natural pigment with a protective effect against UV radiation.8 Demonstrating to individuals the importance of knowing your own phototype, in order to protect your skin from UV rays, avoiding redness, burns, blisters, aging and the emergence of pathologies with AK.…”

“…9,11 Although there is no consensus on the influence of alcohol on the development of AK due to the difficulty of adequately quantifying this parameter, alcohol consumption and other factors, especially smoking, favor the development of these labral lesions. 8,12 It is important to discourage smoking, especially among people exposed to more than one risk factor involved in lip and oral carcinogenesis. 10,12 Likewise, sun exposure for more than 4 hours a day is directly associated with an increased risk of AK, especially in those who do not use sunscreens.…”

“…8,12 It is important to discourage smoking, especially among people exposed to more than one risk factor involved in lip and oral carcinogenesis. 10,12 Likewise, sun exposure for more than 4 hours a day is directly associated with an increased risk of AK, especially in those who do not use sunscreens. 10 Previous studies 9,10,11 that estimated the number of hours confirmed this increased risk of AK.…”

Overview of oral health status and associated risk factors in maritime settings: An updated systematic review

“…This association was demonstrated in another study where the oral cancer was prevalent in 70% of old adult smokers [ 78 ]. Seafaring occupation is characterized by frequent exposure to solar radiation which is the major risk factor of actinic cheilitis and is one of the main reasons for half of lip cancer cases [ 79 , 80 ]. Poor nutrition with less diverse diet of healthy vegetable and fruits at sea is popular on vessels [ 24 ] which may also contribute to the increased risk of oral cancers [ 81 ].…”

p16 INK4a , and p14 ARF Expressions in Carcinogenesis of Squamous Cell Carcinoma of the Lip

“…Actinic cheilitis (AC), which is a pathological condition that particularly affects the lower lip and appears due to chronic and excessive exposure to ultraviolet (UV) radiation in the sunlight, is a potentially malignant lesion that can transform into SCC of the lip. [1][2][3][4][5] According to the 2017 Cancer Statistics Database of the Turkish Ministry of Health, the gender distribution of the agestandardized prevalence rate of lip cancer was 0.9 per 100000 for males and 0.2 per 100000 for females. [6] In a study representing the eastern region of Turkey, it was determined that the majority of lip cancers were encountered in males and that the predominant histopathological subtype was squamous cell carcinoma with a rate of 89%.…”