title: Early-life or lifetime sun exposure, sun reaction, and the risk of squamous cell carcinoma in an Asian population.
abstract: BACKGROUND
  It has been widely accepted that sun exposure is a risk factor of squamous cell carcinoma (SCC) among fair-skinned populations. However, sun exposure and sun reaction have not been explored in Asians and no gender-specific data were available.
  
  
  METHODS
  In a case-control study, 176 incident skin cancer cases were recruited from National Cheng-Kung University Medical Center from 1996 to 1999. Controls included 216 age-, gender-, and residency-matched subjects from the southwestern Taiwan. A questionnaire was administered to collect information on life style and other risk factors. Logistic regression analysis was performed to evaluate the association between sun exposure or sun reaction and the risk of SCC by gender.
  
  
  RESULTS
  Early-age (age 15 to 24) and lifetime sun exposure were significantly associated with increased risk of SCC in a dose-response pattern [odds ratio (OR) = 1.49-3.08, trend p = 0.009 and 0.0007, respectively]. After stratified by gender, the third tertile of early-age sun exposure was significantly associated with the SCC risk among men (OR = 3.08). The second and third tertiles of lifetime sun exposure was significantly associated with SCC risk among women (OR = 3.78 and 4.53, respectively). Skin reaction after 2-h sun exposure during childhood and adolescence was not significantly associated with the risk of SCC.
  
  
  CONCLUSIONS
  Lifetime sun exposure was more related to SCC risk in women, while early-age sun exposure was more relevant to men's SCC risk. This may be attributable to different lifestyle between men and women.
authors.affiliation: Research Center for Genes, Environment, and Human Health, and Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, ROC.
authors.forename: Yen-Ching
authors.initials: YC
authors.lastname: Chen
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
authors.forename: Huey-Jen Jenny
authors.initials: HJ
authors.lastname: Su
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Hsueh
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
authors.forename: Louise M
authors.initials: LM
authors.lastname: Ryan
authors.forename: Sheau-Chiou
authors.initials: SC
authors.lastname: Chao
authors.forename: Julia Yu-Yun
authors.initials: JY
authors.lastname: Lee
authors.forename: Yue-Liang Leon
authors.initials: YL
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000208:ethnology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012878:Skin Neoplasms / Q000453:epidemiology / Q000208:ethnology*; D013471:Sunburn / Q000150:complications* / Q000453:epidemiology; D013472:Sunlight / Q000009:adverse effects*; D013624:Taiwan / Q000453:epidemiology