Photosensitizing agents and the risk of non-melanoma skin cancer: a population-based case-control study.
It is well-known that UV light exposure and a sun-sensitive phenotype are risk factors for the development of non-melanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). In this New Hampshire population-based case-control study, we collected data from 5,072 individuals, including histologically confirmed cases of BCC and SCC, and controls via a personal interview to investigate possible associations between photosensitizing medication use and NMSC. After adjustment for potentially confounding factors (e.g., lifetime number of painful sunburns), we found a modest increase in risk of SCC (odds ratio (OR)=1.2, 95% confidence interval (CI)=1.0-1.4) and BCC (OR=1.2, 95% CI=0.9-1.5), in particular early-onset BCC, (≤ 50 years of age) (OR=1.5, 95% CI=1.1-2.1) associated with photosensitizing medication use. For SCC the association was strongest among those with tendency to sunburn rather than tan. We also specifically found associations with BCC, and especially early-onset BCC, and photosensitizing antimicrobials. In conclusion, certain commonly prescribed photosensitizing medications may enhance the risk of developing SCC, especially in individuals with a sun-sensitive phenotype, and may increase the risk of developing BCC and incidence of BCC at a younger age.
Section of Biostatistics & Epidemiology, Department of Community and Family Medicine, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire 03756, USA.
Sarah N
SN
Robinson
Michael S
MS
Zens
Ann E
AE
Perry
Steven K
SK
Spencer
Eric J
EJ
Duell
Margaret R
MR
Karagas
D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009513:New Hampshire / Q000453:epidemiology; D016017:Odds Ratio; D017319:Photosensitizing Agents / Q000009:adverse effects*; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D013472:Sunlight / Q000009:adverse effects; D014466:Ultraviolet Rays / Q000009:adverse effects
D017319:Photosensitizing Agents