Residential Radon Exposure and Skin Cancer Incidence in a Prospective Danish Cohort.
BACKGROUND
Although exposure to UV radiation is the major risk factor for skin cancer, theoretical models suggest that radon exposure can contribute to risk, and this is supported by ecological studies. We sought to confirm or refute an association between long-term exposure to residential radon and the risk for malignant melanoma (MM) and non-melanoma skin cancer (NMSC) using a prospective cohort design and long-term residential radon exposure.


METHODS
During 1993-1997, we recruited 57,053 Danish persons and collected baseline information. We traced and geocoded all residential addresses of the cohort members and calculated radon concentrations at each address lived in from 1 January 1971 until censor date. Cox proportional hazards models were used to estimate incidence rate-ratios (IRR) and confidence intervals (CI) for the risk associated with radon exposure for NMSC and MM, and effect modification was assessed.


RESULTS
Over a mean follow-up of 13.6 years of 51,445 subjects, there were 3,243 cases of basal cell carcinoma (BCC), 317 cases of squamous cell carcinoma (SCC) and 329 cases of MM. The adjusted IRRs per 100 Bq/m3 increase in residential radon levels for BCC, SCC and MM were 1.14 (95% CI: 1.03, 1.27), 0.90 (95% CI: 0.70, 1.37) and 1.08 (95% CI: 0.77, 1.50), respectively. The association between radon exposure and BCC was stronger among those with higher socio-economic status and those living in apartments at enrollment.


CONCLUSIONS
Long-term residential radon exposure may contribute to development of basal cell carcinoma of the skin. We cannot exclude confounding from sunlight and cannot conclude on causality, as the relationship was stronger amongst persons living in apartments and non-existent amongst those living in single detached homes.
Research Center of Prevention and Heath, Center of Health, Capital region of Denmark, Glostrup Hospital, Glostrup, Denmark; Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Elvira Vaclavik
EV
Bräuner
Department Public Health, Section of Environmental Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Steffen
S
Loft
Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Mette
M
Sørensen
Virus, Lifestyle and Genes, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Allan
A
Jensen
Center for Nuclear Technologies, Technical University of Denmark, Roskilde, Denmark.
Claus Erik
CE
Andersen
National Institute of Radiation Protection, Herlev, Denmark.
Kaare
K
Ulbak
Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Ole
O
Hertel
Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Camilla
C
Pedersen
Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Anne
A
Tjønneland
Virus, Lifestyle and Genes, Danish Cancer Society Research Centre, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Susanne
S
Krüger Kjær
Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Aarhus, Denmark.
Ole
O
Raaschou-Nielsen
D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology; D003718:Denmark; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006798:Housing; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D011446:Prospective Studies; D011886:Radon / Q000633:toxicity*; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D013472:Sunlight; D014466:Ultraviolet Rays
D011886:Radon