title: Association between ambient ultraviolet radiation and risk of esophageal cancer.
abstract: OBJECTIVE
  Ecological studies have suggested an inverse relationship between latitude and risks of some cancers. However, associations between solar ultraviolet radiation (UVR) exposure and esophageal cancer risk have not been fully explored. We therefore investigated the association between nevi, freckles, and measures of ambient UVR over the life-course with risks of esophageal cancers.
  
  
  METHODS
  We compared estimated lifetime residential ambient UVR among Australian patients with esophageal cancer (330 esophageal adenocarcinoma (EAC), 386 esophago-gastric junction adenocarcinoma (EGJAC), and 279 esophageal squamous cell carcinoma (ESCC)), and 1471 population controls. We asked people where they had lived at different periods of their life, and assigned ambient UVR to each location based on measurements from NASA's Total Ozone Mapping Spectrometer database. Freckling and nevus burden were self-reported. We used multivariable logistic regression models to estimate the magnitude of associations between phenotype, ambient UVR, and esophageal cancer risk.
  
  
  RESULTS
  Compared with population controls, patients with EAC and EGJAC were less likely to have high levels of estimated cumulative lifetime ambient UVR (EAC odds ratio (OR) 0.59, 95% confidence interval (CI) 0.35-0.99, EGJAC OR 0.55, 0.34-0.90). We found no association between UVR and risk of ESCC (OR 0.91, 0.51-1.64). The associations were independent of age, sex, body mass index, education, state of recruitment, frequency of reflux, smoking status, alcohol consumption, and H. pylori serostatus. Cases with EAC were also significantly less likely to report high levels of nevi than controls.
  
  
  CONCLUSIONS
  These data show an inverse association between ambient solar UVR at residential locations and risk of EAC and EGJAC, but not ESCC.
authors.affiliation: Cancer Program, Queensland Institute of Medical Research, Brisbane, Australia. Bich.Tran@qimr.edu.au
authors.forename: Bich
authors.initials: B
authors.lastname: Tran
authors.forename: Robyn
authors.initials: R
authors.lastname: Lucas
authors.forename: Michael
authors.initials: M
authors.lastname: Kimlin
authors.forename: David
authors.initials: D
authors.lastname: Whiteman
authors.forename: Rachel
authors.initials: R
authors.lastname: Neale
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology; D004781:Environmental Exposure / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D004943:Esophagogastric Junction / Q000473:pathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008548:Melanosis / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009506:Nevus / Q000453:epidemiology; D016017:Odds Ratio; D010641:Phenotype; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology; D014466:Ultraviolet Rays / Q000009:adverse effects*