title: Minimal and maximal incidence rates of skin cancer in Caucasians estimated by use of sigmoidal UV dose-incidence curves.
abstract: BACKGROUND
  Sigmoidal (S-shaped) dose-cancer incidence relationships are often observed in animal bioassays for carcinogenicity. Ultraviolet (UV) radiation is an established skin carcinogen. The aim of this study is to examine if S-shaped curves describe the relationship between solar UV doses and skin cancer incidences, and if such relationships can be used to estimate threshold levels of non-carcinogenic UV exposure, as well as maximal incidence rates.
  
  
  METHODS
  We studied the incidence rate-annual erythema-effective UV dose relationship for squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and cutaneous melanoma (CM) among different Caucasian populations in Europe, Australia and New Zealand.
  
  
  RESULTS
  Our analysis indicates that S-shaped associations describe the data well (P < 0.0001). The age-adjusted incidence rates for cases expected to be due to other causes than solar UV exposure (at zero UV dose) were found to be around 0.6, 9.7 and 4.0 per 100,000 for women in 1997-2007 for SCC, BCC and CM, respectively, and around 1.2, 14.3 and 2.6 per 100,000 for men. The analysis indicates that SCC, BCC and CM have maximal incidence of 361 ± 24, 1544 ± 49 and 36 ± 4 per 100,000 for women, and 592 ± 35, 2204 ± 109 and 50 ± 4 per 100,000 for men.
  
  
  CONCLUSIONS
  Between 89 and 95% of the annual CM cases, around 99.8% SCC and 99.4% BCC cases are caused by solar UV exposure. The analysis did not identify any "safe" UV dose below which the risk for skin cancer was absent. Avoidance of UV radiation has a potential to reduce the incidence of skin cancer in fair-skinned population.
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Montebello, 0310 Oslo, Norway. Electronic address: asta.juzeniene@rr-reearch.no.
authors.forename: Asta
authors.initials: A
authors.lastname: Juzeniene
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Montebello, 0310 Oslo, Norway.
authors.forename: Mantas
authors.initials: M
authors.lastname: Grigalavicius
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Montebello, 0310 Oslo, Norway.
authors.forename: Zivile
authors.initials: Z
authors.lastname: Baturaite
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Montebello, 0310 Oslo, Norway; Department of Physics, University of Oslo, 0316 Oslo, Norway.
authors.forename: Johan
authors.initials: J
authors.lastname: Moan
mesh_terms: D001315:Australia; D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D005060:Europe; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology*; D008954:Models, Biological; D015233:Models, Statistical; D009520:New Zealand; D012737:Sex Factors; D012867:Skin / Q000473:pathology / Q000528:radiation effects*; D012878:Skin Neoplasms / Q000453:epidemiology*; D013472:Sunlight; D014466:Ultraviolet Rays; D044465:White People; D000096142:Cutaneous Malignant Melanoma
keywords: Basal cell carcinoma; Cutaneous melanoma; Sigmoidal; Skin cancer; Squamous cell carcinoma; Ultraviolet radiation