Exposome and basal cell carcinoma: a multicenter case-control study.
Journal
International journal of dermatology
ISSN: 1365-4632
Titre abrégé: Int J Dermatol
Pays: England
ID NLM: 0243704
Informations de publication
Date de publication:
28 Jan 2024
28 Jan 2024
Historique:
revised:
17
12
2023
received:
17
09
2023
accepted:
02
01
2024
medline:
29
1
2024
pubmed:
29
1
2024
entrez:
29
1
2024
Statut:
aheadofprint
Résumé
While ultraviolet radiation (UVR) present in sunlight is recognized as the main etiological agent of skin cancer, the most frequent form of which is basal cell carcinoma (BCC), other exposome factors like pollution, diet, and lifestyle may also contribute. This study aimed to investigate the association of BCC and exposome-related factors in the Spanish population. BCC cases (n = 119) and controls (n = 127) with no history of skin cancer were recruited between April 2020 and August 2022 by 13 dermatologists throughout Spain in this prospective multicenter case-control study. The BCC group had a higher proportion of outdoor workers, more years of UVR exposure, and a greater consumption of drugs (statins, ASA, hydrochlorothiazide, ACE inhibitors and omeprazole), P < 0.05. Avoidance of sun exposure was the most used photoprotection measure in both groups. The use of hats or caps was higher in the BCC group (P = 0.01). The solar protection factor (SPF) used 15 years previously was higher in the control group (P = 0.04). The control group had a higher daily screen time (P < 0.001), and practiced more relaxation activities (P = 0.03). Higher linolenic acid intake and lower coffee consumption were the only dietary variables associated with BCC (P < 0.05). Statistical significance for all the aforementioned variables was maintained in the multivariate analysis (P < 0.05). The study found a significant association between BCC and multiple exposome-related factors in addition to chronic sun exposure in the Spanish population. Primary prevention strategies should target specific populations, such as outdoor workers, promoting sun-safe behaviors and stress-reducing activities, and also adequate skin photoprotection in patients on certain medications associated with increased BCC risk.
Sections du résumé
BACKGROUND
BACKGROUND
While ultraviolet radiation (UVR) present in sunlight is recognized as the main etiological agent of skin cancer, the most frequent form of which is basal cell carcinoma (BCC), other exposome factors like pollution, diet, and lifestyle may also contribute. This study aimed to investigate the association of BCC and exposome-related factors in the Spanish population.
METHODS
METHODS
BCC cases (n = 119) and controls (n = 127) with no history of skin cancer were recruited between April 2020 and August 2022 by 13 dermatologists throughout Spain in this prospective multicenter case-control study.
RESULTS
RESULTS
The BCC group had a higher proportion of outdoor workers, more years of UVR exposure, and a greater consumption of drugs (statins, ASA, hydrochlorothiazide, ACE inhibitors and omeprazole), P < 0.05. Avoidance of sun exposure was the most used photoprotection measure in both groups. The use of hats or caps was higher in the BCC group (P = 0.01). The solar protection factor (SPF) used 15 years previously was higher in the control group (P = 0.04). The control group had a higher daily screen time (P < 0.001), and practiced more relaxation activities (P = 0.03). Higher linolenic acid intake and lower coffee consumption were the only dietary variables associated with BCC (P < 0.05). Statistical significance for all the aforementioned variables was maintained in the multivariate analysis (P < 0.05).
CONCLUSIONS
CONCLUSIONS
The study found a significant association between BCC and multiple exposome-related factors in addition to chronic sun exposure in the Spanish population. Primary prevention strategies should target specific populations, such as outdoor workers, promoting sun-safe behaviors and stress-reducing activities, and also adequate skin photoprotection in patients on certain medications associated with increased BCC risk.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Authors. International Journal of Dermatology published by Wiley Periodicals LLC on behalf of the International Society of Dermatology.
Références
Wild CP. Complementing the genome with an "exposome": the outstanding challenge of environmental exposure measurement in molecular epidemiology. Cancer Epidemiol Biomarkers Prev. 2005;14(8):1847-1850.
Vineis P, Chadeau-Hyam M, Gmuender H, Gulliver J, Herceg Z, Kleinjans J, et al. The exposome in practice: design of the EXPOsOMICS project. Int J Hyg Environ Health. 2017;220(2 Pt A):142-151.
Holterhues C, Ed V, Louwman MW, Koljenović S, Nijsten T. Incidence and trends of cutaneous malignancies in The Netherlands, 1989-2005. J Invest Dermatol. 2010;130(7):1807-1812.
Tejera-Vaquerizo A, Descalzo-Gallego MA, Otero-Rivas MM, Posada-García C, Rodríguez-Pazos L, Pastushenko I, et al. Skin cancer incidence and mortality in spain: a systematic review and meta-analysis. Actas Dermosifiliogr. 2016;107(4):318-328.
Solar and ultraviolet radiation. IARC Monogr Eval Carcinog Risks Hum. 1992;55:1-316.
Slominski AT, Zmijewski MA, Plonka PM, Szaflarski JP, Paus R. How UV light touches the brain and endocrine system through skin, and why. Endocrinology. 2018;159(5):1992-2007.
de Troya-Martín M, Blázquez-Sánchez N, Rivas-Ruiz F, Fernández-Canedo I, Rupérez-Sandoval A, Pons-Palliser J, et al. Validación de un cuestionario en español sobre comportamientos, actitudes y conocimientos relacionados con la exposición solar [Validation of a Spanish questionnaire to evaluate habits, attitudes, and understanding of exposure to sunlight: "the beach questionnaire"]. Actas Dermosifiliogr. 2009;100(7):586-595. Spanish.
Gilaberte Y, Casanova JM, García-Malinis AJ, Arias-Santiago S, García de la Fuente MR, Pamiés-Gracia M, et al. Skin cancer prevalence in outdoor workers of ski resorts. J Skin Cancer. 2020;28(2020):8128717.
Ruiz-Canela M, Zazpe I, Shivappa N, Hébert JR, Sánchez-Tainta A, Corella D, et al. Dietary inflammatory index and anthropometric measures of obesity in a population sample at high cardiovascular risk from the PREDIMED (PREvención con DIeta MEDiterránea) trial. Br J Nutr. 2015;113(6):984-995.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385-396.
Remor E. Psychometric properties of a European Spanish version of the Perceived Stress Scale (PSS). Span J Psychol. 2006;9(1):86-93.
Kim DP, Kus KJB, Ruiz E. Basal cell carcinoma review. Hematol Oncol Clin North Am. 2019;33(1):13-24.
Chung S. Basal cell carcinoma. Arch Plast Surg. 2012;39(2):166-170.
Robinson JK. Risk of developing another basal cell carcinoma. A 5-year prospective study. Cancer. 1987;60(1):118-120.
Augustin J, Kis A, Sorbe C, Schäfer I, Augustin M. Epidemiology of skin cancer in the German population: impact of socioeconomic and geographic factors. J Eur Acad Dermatol Venereol. 2018;32(11):1906-1913.
Ofenloch RF, Schuttelaar ML, Svensson Å, Bruze M, Naldi L, Cazzaniga S, et al. Socioeconomic status and the prevalence of skin and atopic diseases in five European countries. Acta Derm Venereol. 2019;99(3):309-314.
Zink A, Tizek L, Schielein M, Böhner A, Biedermann T, Wildner M. Different outdoor professions have different risks-a cross-sectional study comparing non-melanoma skin cancer risk among farmers, gardeners and mountain guides. J Eur Acad Dermatol Venereol. 2018;32(10):1695-1701.
Navarro-Bielsa A, Gracia-Cazaña T, García Malinis AJ, Quintana C, Gavín N, Martínez R, et al. Skin cancer prevalence in farm workers in Spain. Eur J Dermatol. 2022;32(6):724-730.
Yoshinaga S, Hauptmann M, Sigurdson AJ, Doody MM, Freedman DM, Alexander BH, et al. Nonmelanoma skin cancer in relation to ionizing radiation exposure among U.S. radiologic technologists. Int J Cancer. 2005;115(5):828-834.
Segatto MM, Bonamigo RR, Hohmann CB, Müller KR, Bakos L, Mastroeni S, et al. Residential and occupational exposure to pesticides may increase risk for cutaneous melanoma: a case-control study conducted in the south of Brazil. Int J Dermatol. 2015;54(12):e527-e538.
Frankel L, Ardeljan AD, Takabe K, Rashid OM. The association between aspirin and basal cell carcinoma: a clinical and financial analysis. World J Oncol. 2022;13(6):343-349.
Yang K, Marley A, Tang H, Song Y, Tang JY, Han J. Statin use and non-melanoma skin cancer risk: a meta-analysis of randomized controlled trials and observational studies. Oncotarget. 2017;8(43):75411-75417.
Kubatka P, Kruzliak P, Rotrekl V, Jelinkova S, Mladosievicova B. Statins in oncological research: from experimental studies to clinical practice. Crit Rev Oncol Hematol. 2014;92(3):296-311.
Alrashidi A, Rhodes LE, Sharif JCH, Kreeshan FC, Farrar MD, Ahad T. Systemic drug photosensitivity-Culprits, impact and investigation in 122 patients. Photodermatol Photoimmunol Photomed. 2020;36(6):441-451.
Goldstein MR, Mascitelli L, Pezzetta F. The double-edged sword of statin immunomodulation. Int J Cardiol. 2009;135(1):128-130.
Götzinger F, Reichrath J, Millenaar D, Lauder L, Meyer MR, Böhm M, et al. Photoinduced skin reactions of cardiovascular drugs-a systematic review. Eur Heart J Cardiovasc Pharmacother. 2022;8(4):420-430.
Mehlan J, Ueberschaar J, Hagenström K, Garbe C, Spitzer MS, Druchkiv V, et al. The use of HCT and/or ACE inhibitors significantly increases the risk of non-melanotic skin cancer in the periocular region. Graefes Arch Clin Exp Ophthalmol. 2022;260(8):2745-2751.
Garrido PM, Borges-Costa J. Hydrochlorothiazide treatment and risk of non-melanoma skin cancer: review of the literature. Rev Port Cardiol. 2020;39(3):163-170. English, Portuguese.
Qasem A, Kasabri V, AbuRish E, Bustanji Y, Al-Hiari Y, Al-Abbasi R, et al. The evaluation of potential cytotoxic effect of different proton pump inhibitors on different human cancer cell lines. Anticancer Agents Med Chem. 2020;20(2):245-253.
Backes C, Religi A, Moccozet L, Vuilleumier L, Vernez D, Bulliard JL. Facial exposure to ultraviolet radiation: Predicted sun protection effectiveness of various hat styles. Photodermatol Photoimmunol Photomed. 2018;34(5):330-337.
Green A, Williams G, Neale R, Hart V, Leslie D, Parsons P, et al. Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet. 1999;354(9180):723-729.
Seviiri M, Law MH, Ong JS, Gharahkhani P, Nyholt DR, Olsen CM, et al. Polyunsaturated fatty acid levels and the risk of keratinocyte cancer: a Mendelian randomization analysis. Cancer Epidemiol Biomarkers Prev. 2021;30(8):1591-1598.
Park MK, Li WQ, Qureshi AA, Cho E. Fat intake and risk of skin cancer in U.S. Adults Cancer Epidemiol Biomarkers Prev. 2018;27(7):776-782.
Black HS, Rhodes LE. Potential benefits of omega-3 fatty acids in non-melanoma skin cancer. J Clin Med. 2016;5(2):23.
Black HS, Rhodes LE. The potential of omega-3 fatty acids in the prevention of non-melanoma skin cancer. Cancer Detect Prev. 2006;30(3):224-232.
Noel SE, Stoneham AC, Olsen CM, Rhodes LE, Green AC. Consumption of omega-3 fatty acids and the risk of skin cancers: a systematic review and meta-analysis. Int J Cancer. 2014;135(1):149-156.
Vaseghi G, Haghjoo-Javanmard S, Naderi J, Eshraghi A, Mahdavi M, Mansourian M. Coffee consumption and risk of nonmelanoma skin cancer: a dose-response meta-analysis. Eur J Cancer Prev. 2018;27(2):164-170.
Rigel DS. Cutaneous ultraviolet exposure and its relationship to the development of skin cancer. J Am Acad Dermatol. 2008;58(5 Suppl 2):S129-S132.
Moehrle M. Outdoor sports and skin cancer. Clin Dermatol. 2008;26(1):12-15.
Dhabhar FS. Psychological stress and immunoprotection versus immunopathology in the skin. Clin Dermatol. 2013;31(1):18-30.