 |
|
Increased Cancer Mortality Following a History of Nonmelanoma Skin Cancer
Henry S. Kahn, MD;
Lilith M. Tatham, DVM, MPH;
Alpa V. Patel, MPH;
Michael J. Thun, MD, MS;
Clark W. Heath, Jr, MD
JAMA. 1998;280:910-912.
Context.— Cancer registries have reported an increased incidence of melanoma and certain noncutaneous cancers following nonmelanoma skin cancer (NMSC). Whether these findings were attributable to intensified surveillance, shared risk factors, or increased cancer susceptibility remains unclear.
Objective.— To determine whether a history of NMSC predicts cancer mortality.
Design.— Prospective cohort with 12-year mortality follow-up adjusted for multiple risk factors.
Setting.— Cancer Prevention Study II, United States and Puerto Rico.
Participants.— Nearly 1.1 million adult volunteers who completed a baseline questionnaire in 1982.
Main Outcome Measure.— Deaths due to all cancers and common cancers.
Results.— After adjusting for age, race, education, smoking, obesity, alcohol use, and other conventional risk factors, a baseline history of NMSC was associated with increased total cancer mortality (men's relative risk [RR], 1.30; 95% confidence interval [CI], 1.23-1.36; women's RR, 1.26; 95% CI, 1.17-1.35). Exclusion of deaths due to melanoma reduced these RRs only slightly. Mortality was increased for the following cancers: melanoma (RR, 3.36 in men, 3.52 in women); pharynx (RR, 2.77 in men, 2.81 in women); lung (RR, 1.37 in men, 1.46 in women); non-Hodgkin lymphoma (RR, 1.32 in men, 1.50 in women); in men only, salivary glands (RR, 2.96), prostate (RR, 1.28), testis (RR, 12.7), urinary bladder (RR, 1.41), and leukemia (RR, 1.37); and in women only, breast (RR, 1.34). All-cause mortality was slightly increased (adjusted men's RR, 1.03 [95% CI, 1.00-1.06]; women's RR, 1.04 [95% CI, 1.00-1.09]).
Conclusions.— Persons with a history of NMSC are at increased risk of cancer mortality. Although the biological mechanisms are unknown, a history of NMSC should increase the clinician's alertness for certain noncutaneous cancers as well as melanoma.
From the Department of Family and Preventive Medicine, Emory University School of Medicine (Dr Kahn), and the Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Ga. Dr Tatham is now with the Agency for Toxic Substances and Disease Registry, Atlanta.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Risk of Second Primary Cancer and Death Following a Diagnosis of Nonmelanoma Skin Cancer
Nugent et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:2584-2590.
ABSTRACT
| FULL TEXT
Primary Defect in UVB-Induced Systemic Immunomodulation Does Not Relate to Immature or Functionally Impaired APCs in Regional Lymph Nodes
Gorman et al.
J. Immunol. 2005;174:6677-6685.
ABSTRACT
| FULL TEXT
Fatty Acid Composition of Red Blood Cell Membranes and Risk of Squamous Cell Carcinoma of the Skin
Harris et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:906-912.
ABSTRACT
| FULL TEXT
Ultraviolet Radiation Exposure and Risk of Malignant Lymphomas
Smedby et al.
JNCI J Natl Cancer Inst 2005;97:199-209.
ABSTRACT
| FULL TEXT
Blood Transfusion and Risk of Non-Hodgkin's Lymphoma in Connecticut Women
Zhang et al.
Am J Epidemiol 2004;160:325-330.
ABSTRACT
| FULL TEXT
XPD Polymorphism and Risk of Subsequent Cancer in Individuals with Nonmelanoma Skin Cancer
Brewster et al.
Cancer Epidemiol. Biomarkers Prev. 2004;13:1271-1275.
ABSTRACT
| FULL TEXT
Basal cell carcinoma
Wong et al.
BMJ 2003;327:794-798.
FULL TEXT
A specific haplotype of single nucleotide polymorphisms on chromosome 19q13.2-3 encompassing the gene RAI is indicative of post-menopausal breast cancer before age 55
Nexo et al.
Carcinogenesis 2003;24:899-904.
ABSTRACT
| FULL TEXT
The E6 and E7 Proteins of the Cutaneous Human Papillomavirus Type 38 Display Transforming Properties
Caldeira et al.
J. Virol. 2003;77:2195-2206.
ABSTRACT
| FULL TEXT
Sunlight-induced DNA damage in human mononuclear cells
MOLLER et al.
FASEB J. 2002;16:45-53.
ABSTRACT
| FULL TEXT
Continue Reading
Anderson et al.
Arch Dermatol 2001;137:1105-1106.
FULL TEXT
Epidemiological Research at the American Cancer Society
Thun et al.
Cancer Epidemiol. Biomarkers Prev. 2000;9:861-868.
FULL TEXT
Impact of Global Genome Repair versus Transcription-coupled Repair on Ultraviolet Carcinogenesis in Hairless Mice
Berg et al.
Cancer Res. 2000;60:2858-2863.
ABSTRACT
| FULL TEXT
Is History of Squamous-Cell Skin Cancer a Marker of Poor Prognosis in Patients with Cancer?
Askling et al.
ANN INTERN MED 1999;131:655-659.
ABSTRACT
| FULL TEXT
Fas Ligand: A Sensor for DNA Damage Critical in Skin Cancer Etiology
Hill et al.
Science 1999;285:898-900.
ABSTRACT
| FULL TEXT
Cancer Mortality After Nonmelanoma Skin Cancer
Spratt et al.
JAMA 1999;281:325-325.
FULL TEXT
|
