title: Metabolic risk factors and skin cancer in the Metabolic Syndrome and Cancer Project (Me-Can).
abstract: BACKGROUND
  Little is known about the associations of metabolic aberrations with malignant melanoma (MM) and nonmelanoma skin cancer (NMSC).
  
  
  OBJECTIVE
  To assess the associations between metabolic factors (both individually and combined) and the risk of skin cancer in the large prospective Metabolic Syndrome and Cancer Project (Me-Can).
  
  
  METHODS
  During a mean follow-up of 12 years of the Me-Can cohort, 1728 (41% women) incident MM, 230 (23% women) fatal MM and 1145 (33% women) NMSC were identified. Most NMSC cases (76%) were squamous cell carcinoma (SCC) (873, 33% women). Hazard ratios (HRs) were estimated by Cox proportional hazards regression for quintiles and standardized z-scores (with a mean of 0 and SD of 1) of body mass index (BMI), blood pressure, glucose, cholesterol, triglycerides and for a combined metabolic syndrome score. Risk estimates were corrected for random error in the measurements.
  
  
  RESULTS
  Blood pressure per unit increase of z-score was associated with an increased risk of incident MM cases in men and women [HR 1·17, 95% confidence interval (CI) 1·04-1·31 and HR 1·18, 95% CI 1·03-1·36, respectively] and fatal MM cases among women (HR 2·39, 95% CI 1·58-3·64). In men, all quintiles for BMI above the reference were associated with a higher risk of incident MM. In women, SCC NMSC risk increased across quintiles for glucose levels (P-trend 0·02) and there was a trend with triglyceride concentration (P-trend 0·09).
  
  
  CONCLUSIONS
  These findings suggest that mechanisms linked to blood pressure may be involved in the pathogenesis of MM. SCC NMSC in women could be related to glucose and lipid metabolism.
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081 Ulm, Germany. gabriele.nagel@uni-ulm.de
authors.forename: G
authors.initials: G
authors.lastname: Nagel
authors.forename: T
authors.initials: T
authors.lastname: Bjørge
authors.forename: T
authors.initials: T
authors.lastname: Stocks
authors.forename: J
authors.initials: J
authors.lastname: Manjer
authors.forename: G
authors.initials: G
authors.lastname: Hallmans
authors.forename: M
authors.initials: M
authors.lastname: Edlinger
authors.forename: C
authors.initials: C
authors.lastname: Häggström
authors.forename: A
authors.initials: A
authors.lastname: Engeland
authors.forename: D
authors.initials: D
authors.lastname: Johansen
authors.forename: A
authors.initials: A
authors.lastname: Kleiner
authors.forename: R
authors.initials: R
authors.lastname: Selmer
authors.forename: H
authors.initials: H
authors.lastname: Ulmer
authors.forename: S
authors.initials: S
authors.lastname: Tretli
authors.forename: H
authors.initials: H
authors.lastname: Jonsson
authors.forename: H
authors.initials: H
authors.lastname: Concin
authors.forename: P
authors.initials: P
authors.lastname: Stattin
authors.forename: A
authors.initials: A
authors.lastname: Lukanova
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D013548:Sweden / Q000453:epidemiology