Skin tumor risk among atomic-bomb survivors in Japan.
OBJECTIVE
Elevated risks of skin cancer following high doses of ionizing radiation have long been known. Recent reports on atomic-bomb survivors indicate that nonmelanoma skin cancer can be induced at low to medium doses. We studied atomic-bomb survivors to determine the effects of radiation on specific histologic types of skin cancer and to describe the dose-response relationship.


METHODS
Cases of melanoma, nonmelanoma skin cancers, and Bowen's disease were ascertained between 1958 and 1987 for the 80,000 cohort members through the population-based Hiroshima and Nagasaki (Japan) tumor registries augmented by searches of other records.


RESULTS
An excess of basal cell carcinoma (n = 80), with some suggestion of a non-linear dose-response, was observed. The excess risk decreased markedly as age at exposure increased, and there was no evidence for an interaction between ionizing and ultraviolet radiation. No dose-response was found for squamous cell carcinoma (n = 69). The excess relative risk point-estimates were large, but statistically nonsignificant for both melanoma (n = 10) and Bowen's disease (n = 26).


CONCLUSIONS
The basal layer of the epidermis appears to be quite sensitive to radiation carcinogenesis, particularly at a young age. The suprabasal layer seems to be more resistant, as shown by the lack of an association for squamous cell carcinomas.
Ron
E
E
Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Preston
D L
DL
Kishikawa
M
M
Kobuke
T
T
Iseki
M
M
Tokuoka
S
S
Tokunaga
M
M
Mabuchi
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D001913:Bowen's Disease / Q000453:epidemiology / Q000209:etiology; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009689:Nuclear Warfare; D016012:Poisson Distribution; D012042:Registries; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology; D017741:Survivors / Q000706:statistics & numerical data*