title: Skin microtopography as a measure of photoaging and risk of squamous cell carcinoma of the skin in a US population.
abstract: BACKGROUND
  Skin microtopography as a measure of photoaging is a noninvasive approach to measuring chronic ultraviolet radiation exposure and reflects the degree of dermal elastosis in populations of European descent in the subtropics. Less is known about the utility of this approach in populations at different latitudes, and whether it relates to skin cancer risk.
  
  
  METHODS
  A population-based case-control study of 342 squamous cell carcinoma (SCC) cases and 331 age- and gender-matched controls were evaluated for histologic evidence of solar damage and severity of photoaging based on microtopography on a six-grade scale. Odds ratios (OR) for SCC associated with degree of photoaging were estimated using logistic regression analysis adjusted for potentially confounding factors.
  
  
  RESULTS
  After adjustment for known risk factors, SCC was associated with increasing photoaging grade (OR = 1.7, 95% CI = 0.9-3.0 for severe photoaging; OR = 2.8, 95% CI = 1.6-5.0 for very severe photoaging). Associations remained among those with actinic keratosis (OR = 3.4, 95% CI = 0.9-12.4 for severe photoaging, OR = 5.7, 95% CI = 1.7-19.6 for very severe photoaging).
  
  
  CONCLUSIONS
  There was limited statistical power, particularly for subgroup analyses.
  
  
  CONCLUSIONS
  Our findings provide further evidence of microtopography as an independent, objective indicator of risk of SCC.
authors.affiliation: Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, US.
authors.forename: Lawrence Fitzgerald
authors.initials: LF
authors.lastname: Kuklinski
authors.affiliation: Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, US.
authors.forename: Michael Scot
authors.initials: MS
authors.lastname: Zens
authors.affiliation: Department of Pathology, The Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, US.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Perry
authors.affiliation: Cancer and Population Studies, Queensland Institute of Medical Research, Brisbane, Qld, Australia.|Cancer Research UK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, UK.
authors.forename: Adele C
authors.initials: AC
authors.lastname: Green
authors.affiliation: Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, US.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Karagas
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D004548:Elasticity / Q000528:radiation effects; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009513:New Hampshire / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods; D012867:Skin / Q000473:pathology*; D015595:Skin Aging / Q000473:pathology*; D012878:Skin Neoplasms / Q000453:epidemiology*
keywords: microtopography; photoaging; squamous cell carcinoma; ultraviolet radiation