Skip to main content

Sun exposure and non-melanocytic skin cancer

Cancer Causes & Control volume 5, pages 367–392 (1994)Cite this article

Abstract

Non-melanocytic skin cancer has long been regarded as one of the harmful effects of solar ultraviolet (UV) radiation on human health. In this review, we examine epidemiologic evidence linking sun exposure and skin cancer coming from both descriptive studies in populations and analytical studies involving estimates of exposure in individuals. Particular attention is given to the quality of the published data. The epidemiologic evidence that sun exposure causes skin cancer is mainly indirect. Incidence or mortality is inversely related to latitude in populations of mainly European origin (e.g., the United States, Australia), and is higher in people born in Australia (high ambient solar radiation) than in migrants to Australia from the United Kingdom (lower ambient radiation). Skin cancer occurs mainly at sun-exposed body sites and in people who are sensitive to the sun; a reduced capacity to repair UV-induced DNA damage appears to increase the risk. The direct evidence linking sun exposure and skin cancer is weaker with few well-conducted studies of sun exposure in individuals. Mostly, studies of total sun exposure have not found statistically significant positive associations; those that did, had not adjusted for potential confounding by age and gender and thus their interpretation is limited. Studies of occupational sun exposure had relative risks not greater than 2.0; recreational exposure has been little studied. Other measurements, less direct but potentially less prone to measurement error, are sunburn (not evidently associated with skin cancer risk) and indicators of benign cutaneous sun-damage (strongly associated but lacking empirical evidence that sun exposure is their main cause). Many questions remain about the relationship between sun exposure and skin cancer.Cancer Causes and Control 1994, 5, 367–392

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Scotto J, Fears TR, Fraumeni JF Jr.Incidence of Nonmelanoma Skin Cancer in the United States. Bethesda, MD (US): National Cancer Institute, 1983; NIH Pub. No. 82-2433.

    Google Scholar 

  2. Marks R, Staples M, Giles GG. Trends in non melanocytic skin cancer treated in Australia: the second national survey.Int J Cancer 1993;53: 585–90.

    PubMed  Google Scholar 

  3. Parkin DM, Muir CS, Whelan SL, Gao Y-T, Ferlay J, Powell J (eds),Cancer Incidence in Five Continents, Volume 6. Lyon, France: IARC, 1992; IARC Sci. Pub. No. 120.

    Google Scholar 

  4. Gallagher RP, Ma B, McLean DI, et al. Trends in basal cell carcinoma, squamous cell carcinoma, and melanoma of the skin from 1973 through 1987.J Am Acad Dermatol 1990;23: 413–21.

    PubMed  Google Scholar 

  5. Roberts DL. Incidence of non-melanoma skin cancer in West Glamorgan, South Wales.Br J Dermatol 1990;122: 399–403.

    PubMed  Google Scholar 

  6. Weinstock M, Bogaars HA, Ashley M, Litle V, Bilodeau E, Kimmel S. Nonmelanoma skin cancer mortality. A population-based study.Arch Dermatol 1991;127: 1194–7.

    PubMed  Google Scholar 

  7. Østerlind A, Hjalgrim H, Kulinsky B, Frentz G. Skin cancer as a cause of death in Denmark.Br J Dermatol 1991;125: 580–2.

    PubMed  Google Scholar 

  8. Giles GG, Armstrong BK, Smith LN.Cancer in Australia 1982. Canberra: Australian Institute of Health and Australasian Association of Cancer Registries, 1987.

    Google Scholar 

  9. Giles GG, Marks R, Foley P. Incidence of non-melanocytic skin cancer treated in Australia.Br Med J 1988;296: 13–17.

    Google Scholar 

  10. Murphy GF, Elder DE.Atlas of Tumor Pathology. Third Series, Fascicle 1. Non-melanocytic Tumors of the Skin. Washington, DC: Armed Forces Institute of Pathology, 1991.

    Google Scholar 

  11. Nixon RL, Dorevitch AP, Marks R. Squamous cell cancer of the skin.Med J Aust 1986;144: 235–9.

    PubMed  Google Scholar 

  12. Emmett AJ, Broadbent G. Basal cell carcinoma in Queensland.Aust NZ J Surg 1981;51: 576–90.

    Google Scholar 

  13. Miller SJ. Biology of basal cell carcinoma (Part 1).J Am Acad Dermatol 1991;24: 1–13.

    PubMed  Google Scholar 

  14. Australian Bureau of Statistics.Year Book Australia 1988. Canberra, Australia: Commonwealth Government Printer, 1988.

    Google Scholar 

  15. Armstrong BK. The epidemiology and prevention of cancer in Australia.Aust NZ J Surg 1988;58: 179–87.

    Google Scholar 

  16. Blum H. Sunlight as a causal factor in cancer of the skin in man.JNCI 1948;9: 247–58.

    Google Scholar 

  17. Emmett EA, Ultraviolet radiation as a cause of skin tumours.CRC Crit Rev Toxicol 1973;2: 211–55.

    PubMed  Google Scholar 

  18. Fitzpatrick TB, Pathak MA, Magnus IA, Curwen WL. Abnormal reactions of man to light.Annu Rev Med 1963;14: 195–214.

    PubMed  Google Scholar 

  19. Urbach F. Geographic pathology of skin cancer. In: Urbach F ed.Biologic Effects of UVR with Emphasis on the Skin. Oxford, UK: Pergamon Press, 1969: 635–50.

    Google Scholar 

  20. Gordon D, Silverstone H, Smithurst BA. The epidemiology of skin cancer in Australia. In: McCarthy WH, ed.Melanoma and Skin Cancer. Sydney, Australia: Government Printer, 1972: 1–37.

    Google Scholar 

  21. International Agency for Research on Cancer.Solar and Ultraviolet Radiation. Lyon, France: IARC, 1992;IARC Monogr Eval Carcinog Risks Humans, Vol. 55.

    Google Scholar 

  22. United Nations Environment Programme Environmental Effects Panel.Environmental Effects of Ozone Depletion: 1991 Update. Nairobi, Kenya: UNEP, 1991.

    Google Scholar 

  23. Muir C, Waterhouse J, Mack T, Powell J, Whelan S, eds.Cancer Incidence in Five Continents, Volume V. Lyon, France: IARC, 1987; IARC Sci. Pub. No. 88.

    Google Scholar 

  24. Stenbeck KD, Balanda KP, Williams MJ, et al. Patterns of treated non-melanoma skin cancer in Queensland—the region with the highest incidence rates in the world.Med J Aust 1990;153: 511–15.

    PubMed  Google Scholar 

  25. Kricker A, English DR, Randell PL, et al. Skin cancer in Geraldton, Western Australia: a survey of incidence and prevalence.Med J Aust 1990;152: 399–407.

    PubMed  Google Scholar 

  26. Gordon D, Silverstone H. Worldwide epidemiology of premalignant and malignant cutaneous lesions. In: Andrade R, Gumport SL, Popkin GL, Rees TD, eds.Cancer of the Skin, Vol. 1. London, UK: WB Saunders, 1976: 405–34.

    Google Scholar 

  27. Green AFS, Findlay GB, Klenk KF, Wilson WM, Mo T. The ultraviolet dose dependence of non-melanoma skin cancer incidence.Photochem Photobiol 1976;24: 353–62.

    PubMed  Google Scholar 

  28. Armstrong BK. Melanoma of the skin.Br Med Bull 1984;40: 346–50.

    PubMed  Google Scholar 

  29. Mountin JW, Dorn H. Some peculiarities in the geography of cancer.JAMA 1939;113: 2405–10.

    Google Scholar 

  30. Dorn HF. Illness from cancer in the United States.Public Health Rep 1944;59: 33–48.

    Google Scholar 

  31. Dorn HF. Illness from cancer in the United States.Public Health Rep 1944;59: 97–115.

    Google Scholar 

  32. Auerbach H, Geographic variation in incidence of skin cancer in the United States.Public Health Rep 1961;76: 345–8.

    PubMed  Google Scholar 

  33. Haenszel W. Variations in skin cancer incidence within the United States.NCI Monogr, 1963;10: 225–43.

    Google Scholar 

  34. Scotto J, Kopf AW, Urbach F. Non-melanoma skin cancer among. Caucasians in four areas of the United States.Cancer 1974;34: 1333–8.

    PubMed  Google Scholar 

  35. Scotto J, Fears TR, Fraumeni JF Jr. Solar radiation. In: Schottenfeld D, Fraumeni JF Jr, eds.Cancer Epidemiology and Prevention. Philadelphia, PA (US): WB Saunders, 1982: 254–76.

    Google Scholar 

  36. Serrano H, Scotto J, Shornick G, Fears TR, Greenberg ER. Incidence of nonmelanoma skin cancer in New Hampshire and Vermont.J Am Acad Dermatol 1991;24: 574–9.

    PubMed  Google Scholar 

  37. Moan J, Dahlback A, Henriksen T, Magnus K. Biological amplification factor for sunlight-induced nonmelanoma skin cancer at high latitudes.Cancer Res 1989;49: 5207–12.

    PubMed  Google Scholar 

  38. Teppo L, Pukkala E, Hakama M, Hakulinen T, Herva A, Saxen E. Way of life and cancer incidence in Finland. Amunicipality-based ecological analysis.Scand J Soc Med 1980;19 (Suppl): 5–84.

    Google Scholar 

  39. Silverstone H, Gordon D. Regional studies in skin cancer. Second report: wet tropical and subtropical coasts of Queensland.Med J Aust 1966;16: 733–40.

    Google Scholar 

  40. Elwood JM, Lee JAH, Walter SD, Mo T, Green AES. Relationship of melanoma and other skin cancer mortality to latitude and ultraviolet radiation in the United States and Canada.Int J Epidemiol 1974;3: 325–32.

    PubMed  Google Scholar 

  41. Armstrong BK, Woodings T, Stenhouse NS, McCall MG. Mortality from cancer in migrants to Australia—1962–1971. Perth: University of Western Australia, 1983.

    Google Scholar 

  42. Shanmugaratnam K, Lee HP, Day NE.Cancer Incidence in Singapore 1968–1977. Lyon, France: IARC, 1983; IARC Sci. Pub. No. 47.

    Google Scholar 

  43. Østerlind A, Hou-Jensen K, Jensen OM. Incidence of cutaneous malignant melanoma in Denmark 1978–1982. Anatomic site distribution, histologic types, and comparison with non-melanoma skin cancer.Br J Cancer 1988;58: 385–91.

    PubMed  Google Scholar 

  44. Levi F, La Vecchia C, Te V-C, Mezzanotte G. Descriptive epidemiology of skin cancer in the Swiss canton of Vaud.Int J Cancer 1988;42: 811–16.

    PubMed  Google Scholar 

  45. Green A, Battistutta D. Incidence and determinants of skin cancer in a high-risk Australian population.Int J Cancer 1990;46: 356–61.

    PubMed  Google Scholar 

  46. Magnus K. The Nordic profile of skin cancer incidence. A comparative epidemiological study of the three main types of skin cancer.Int J Cancer 1991;47: 12–19.

    PubMed  Google Scholar 

  47. Oettlé AG. Skin cancer in Africa.NCI Monogr 1963;10: 197–214.

    Google Scholar 

  48. Tasmanian Cancer Registry.Cancer in Tasmania Incidence and Mortality 1986. Hobart, Australia: Artemis Publishing Consultants, 1990.

    Google Scholar 

  49. Diffey BL, Tate TJ, Davis A. Solar dosimetry of the face: the relationship of natural ultraviolet radiation exposure to basal cell carcinoma localisation.Phys Med Biol 1979;24: 931–9.

    PubMed  Google Scholar 

  50. Fitzpatrick TB, Sober AJ. Sunlight and skin cancer.N Engl J Med 1985;313: 818–20.

    PubMed  Google Scholar 

  51. Hoffman JS. Non-melanoma skin tumours. In: Hoffman JS, ed.Assessing the Risks of Trace gases that Can Modify the Stratosphere, Vol. 3. Washington, DC: Office of Air and Radiation, US Environmental Protection Agency, 1987: 7–1 to 7–66.

    Google Scholar 

  52. Urbach F. Cutaneous photocarcinogenesis.J Environ Sci Health—Environ Carcinogen Rev 1987;C5: 211–34.

    Google Scholar 

  53. Doll R, Muir C, Waterhouse J, eds.Cancer Incidence in Five Continents, Volume II. Berlin: Springer, 1970.

    Google Scholar 

  54. Waterhouse J, Muir C, Correa P, Powell J (eds).Cancer Incidence in Five Continents, Volume III. Lyon, France: IARC, 1976; IARC Sci. Pub. No. 15.

    Google Scholar 

  55. Waterhouse J, Muir C, Shanmugaratnam K, Powell J (eds).Cancer Incidence in Five Continents, Volume IV. Lyon, France: IARC, 1982; IARC Sci. Pub. No. 42.

    Google Scholar 

  56. Oluwasanmi JO, Williams AO, Alli AF. Superficial cancer in Nigeria.Br J Cancer 1969;23: 714–28.

    PubMed  Google Scholar 

  57. Rippey J, Schmaman A. Skin tumours of Africans. In: Marshall J, ed.Essays on Tropical Dermatology, Vol. 2. Amsterdam, The Netherlands: Excerpta Medica, 1972: 98–115.

    Google Scholar 

  58. Isaacson C, Selzer G, Kaye V, et al. Cancer in the urban blacks of South Africa.S Afr Cancer Bull 1978;22: 49–84.

    Google Scholar 

  59. Rose EF. Pigment variation in relation to protection and susceptibility to cancer.Pigment Cell 1973;1: 236–45.

    Google Scholar 

  60. Mora RG, Burris R. Cancer of the skin in blacks: a review of 128 patients with Basal-cell carcinoma.Cancer 1981;47: 1436–8.

    PubMed  Google Scholar 

  61. Foster HM, Webb SJ. Skin cancer in the North Solomons.Aust NZ J Surg 1988;58: 397–401.

    Google Scholar 

  62. Paksoy N, Bouchardy C, Parkin DM, Cancer incidence in Western Samoa.Int J Epidemiol 1991;20: 634–41.

    PubMed  Google Scholar 

  63. Molesworth EH. Rodent ulcer.Med J Aust 1927;1: 878–99.

    Google Scholar 

  64. Atkin M, Fenning J, Heady JA, Kennaway EL, Kennaway NM. The mortality from cancer of the skin and lip in certain occupations.Br J Cancer 1949;3: 1–15.

    Google Scholar 

  65. Whitaker CJ, Lee WR, Downes JE. Squamous cell cancer in the North-west of England, 1967–69, and its relation to occupation.Br J Ind Med 1979;36: 43–51.

    PubMed  Google Scholar 

  66. Beral V, Robinson N. The relationship of malignant melanoma, basal and squamous skin cancers to indoor and outdoor work.Br J Cancer 1981,44: 886–91.

    PubMed  Google Scholar 

  67. Vågerö D, Ringback G, Kiviranta H. Melanoma and other tumours of the skin among office, other indoor and outdoor workers in Sweden 1961–1979.Br J Cancer 1986,53: 507–12.

    PubMed  Google Scholar 

  68. Urbach F. The biological effects of increased ultraviolet radiation: an update.Photochem Photobiol 1989;50: 439–41.

    PubMed  Google Scholar 

  69. Fears TR, Scotto J. Estimating increases in skin cancer morbidity due to increases in ultraviolet radiation exposure.Cancer Invest 1983;1: 119–26.

    PubMed  Google Scholar 

  70. Glass AG, Hoover RN. The emerging epidemic of melanoma and squamous cell skin cancer.JAMA 1989;262: 2097–100.

    PubMed  Google Scholar 

  71. Coebergh JWW, Neumann HAM, Vrints LW, Van der Heijden L, Meijer WJ, Verhagen-Teulings MT. Trends in the incidence of non-melanoma-skin cancer in the SE Netherlands 1975–1988: a registry-based study.Br J Dermatol 1991;125: 353–9.

    PubMed  Google Scholar 

  72. Kricker A, Armstrong BK, Jones ME, Burton RC.International Research Programme on Health Solar UV Radiation and Environmental Change. Lyon. France: IARC, 1993; IARC Tech. Rep. No. 13.

    Google Scholar 

  73. Fears TR, Scotto J. Changes in skin cancer morbidity between 1971–72 and 1977–78.JNCI 1982;69: 365–70.

    PubMed  Google Scholar 

  74. Kaldor J, Shugg D, Young B, Dwyer T, Wang Y-G. Non-melanoma skin cancer: ten years of cancer-registry-based surveillance.Int J Cancer 1993;53: 886–91.

    PubMed  Google Scholar 

  75. Bechtel MA, Callen JP, Owen LG. Etiologic agents in the development of skin cancer.Clin Plastic Surg 1980;7: 265–75.

    Google Scholar 

  76. McCarthy WH, Shaw HM. Skin cancer in Australia.Med J Aust 1989;150: 469–70.

    PubMed  Google Scholar 

  77. Karjalainen S, Salo H, Teppo L. Basal cell and squamous cell carcinoma of the skin in Finland.Int J Dermatol 1989;28: 445–50.

    PubMed  Google Scholar 

  78. Brodkin RH, Kopf AW, Andrade R. Basal-cell epithelioma and elastosis: a comparison of distribution. In: Urbach F, ed.Biologic Effects of Ultraviolet Radiation. Oxford, UK: Pergamon Press, 1969: 581–618.

    Google Scholar 

  79. Goodman GJ, Marks R, Selwood TS, Ponsford MW, Pakes W. Non-melanocytic skin cancer and solar keratoses in Victoria—clinical studies II.Aust J Dermatol 1984;25: 103–6.

    Google Scholar 

  80. Marks R, Jolley D, Dorevitch AP, Selwood TS. The incidence of non-melanocytic skin cancers in an Australian population: results of a five-year prospective study.Med J Aust 1989;150: 475–8.

    PubMed  Google Scholar 

  81. Diffey BL, Kerwin M, Davis A. The anatomical distribution of sunlight.Br J Dermatol 1977;97: 407–10.

    PubMed  Google Scholar 

  82. Lancaster HO, Nelson J. Sunlight as a cause of melanoma: a clinical survey.Med J Aust 1957;1: 452–6.

    Google Scholar 

  83. Gellin GA, Kopf AW, Garfinkel L. Basal cell epithelioma. A controlled study of associated factors.Arch Dermatol 1965;91: 38–45.

    PubMed  Google Scholar 

  84. Lane-Brown MM, Sharpe CAB, Macmillan DS, McGovern VJ. Genetic predisposition to melanoma and other skin cancers in Australian.Med J Aust 1971;1: 852–3.

    PubMed  Google Scholar 

  85. Urbach F, Rose DB, Bonnem M. Genetic and environmental interactions in skin carcinogenesis. In:Environmental Cancer. A collection of papers presented at the 24th Annual Symposium on Fundamental Cancer Research, 1971, published for the University of Texas at Houston. Baltimore, MD (US): Williams & Wilkins, 1972: 355–71.

    Google Scholar 

  86. Aubry F, MacGibbon B. Risk factors of squamous cell carcinoma of the skin. A case-control study in the Montreal region.Cancer 1985;55: 907–11.

    PubMed  Google Scholar 

  87. O'Loughlin C, Moriarty MJ, Herity B, Daly L. A reappraisal of risk factors for skin carcinoma in Ireland.Irish J Med Sci 1985;154: 61–5.

    PubMed  Google Scholar 

  88. Herity B, O'Loughlin G, Moriarty MJ, Conroy R. Risk factors for non-melanoma skin cancer.Irish Med J 1989;82: 151–2.

    Google Scholar 

  89. Gafá L, Filippazzo MG, Tumino R, Dardoni G, Lanzarone F, Dardoni L. Risk factors of nonmelanoma skin cancer in Ragusa, Sicily: a case-control study.Cancer Causes Control 1991;2: 395–9.

    PubMed  Google Scholar 

  90. Silverstone H, Searle JHA. The epidemiology of skin cancer in Queensland: the influence of phenotype and environment.Br J Cancer 1970;24: 235–52.

    PubMed  Google Scholar 

  91. O'Beirn SF, Judge P, Urbach F, MacCon CF, Martin F. Skin cancer in County Galway, Ireland.Proc Natl Cancer Conf 1970;6: 489–500.

    PubMed  Google Scholar 

  92. Holman CDJ, Armstrong BK, Evans PR, et al. Relationship of solar keratosis and history of skin cancer to objective measures of actinic skin damage.Br J Dermatol 1984;110: 129–38.

    PubMed  Google Scholar 

  93. Robinson JK. Risk of developing another basal cell carcinoma. A 5 year prospective study.Cancer 1987;60: 118–20.

    PubMed  Google Scholar 

  94. Engel A, Johnson M-L, Haynes SG. Health effects of sunlight exposure in the United States.Arch Dermatol 1988;124: 72–9.

    PubMed  Google Scholar 

  95. Green A, Beardmore G, Hart V, Leslie D, Marks R. Skin cancer in a Queensland population.J Am Acad Dermatol 1988;19: 1045–52.

    PubMed  Google Scholar 

  96. Hogan DJ, To T, Gran L, et al. Risk factors for basal cell carcinoma.Int J Dermatol 1989;28: 591–4.

    PubMed  Google Scholar 

  97. Hogan DJ, Lane PR, Gran L, et al. Risk factors for squamous cell carcinoma of the skin in Saskatchewan, Canada.J Dermatol Sci 1990;1: 97–100.

    PubMed  Google Scholar 

  98. Vitasa BC, Taylor HR, Strickland PT, et al. Association of nonmelanoma skin cancer and actinic keratosis with cumulative solar ultraviolet exposure in Maryland watermen.Cancer 1990;65: 2811–17.

    PubMed  Google Scholar 

  99. Hunter DJ, Colditz GA, Stampfer MJ, Rosner B, Willett WC, Speizer FE. Risk factors for basal cell carcinoma in a prospective cohort of women.Ann Epidemiol 1990;1: 13–23.

    PubMed  Google Scholar 

  100. Kricker A, Armstrong BK, English DR, Heenan PJ. Pigmentary and cutaneous risk factors for non-melanocytic skin cancer—a case-control study.Int J Cancer 1991;48: 650–62.

    PubMed  Google Scholar 

  101. Statistics and Epidemiology Research Corporation.EGRET. Seattle, WA (US): SERC, 1990.

    Google Scholar 

  102. Elliott JA, Welton DG. Epithelioma.Arch Dermatol Syphil 1946;53: 307–32.

    Google Scholar 

  103. Robins AH.Biological Perspectives on Human Pigmentation. Cambridge, UK: Cambridge University Press, 1991.

    Google Scholar 

  104. Holman CDJ, Evans PR, Lumsden GJ, Armstrong BK. The determinants of actinic skin damage: problems of confounding among environmental and constitutional variables.Am J Epidemiol 1984;120: 414–22.

    PubMed  Google Scholar 

  105. Green A, O'Rourke MGE. Cutaneous malignant melanoma in association with other skin cancers.JNCI 1985;74: 977–80.

    PubMed  Google Scholar 

  106. Armstrong BK. Epidemiology of malignant melanoma: intermittent or total accumulated exposure to the sun?J Dermatol Surg Oncol 1988;18: 835–49.

    Google Scholar 

  107. Nicholls EM. Genetic susceptibility and somatic mutation in the production of frekles, birthmarks and moles.Lancet 1968;i: 71–3.

    Google Scholar 

  108. Easton DF, Cox GM, MacDonald AM, Ponder BAJ. Genetic susceptibility to naevi—atwin study.Br J Cancer 1991;64: 1164–7.

    PubMed  Google Scholar 

  109. Gallagher RP, McLean DI, Yang CP, et al. Suntan, sunburn and pigmentation factors and the frequency of acquired melanocytic nevi in children.Arch Dermatol 1990;126: 770–6.

    PubMed  Google Scholar 

  110. Coombes BD, Sharples KJ, Cooke KR, Skegg DCG, Elwood JM. Variation and covariates of the number of benign nevi in adolescents.Am J Epidemiol 1992;136: 344–55.

    PubMed  Google Scholar 

  111. Marks R. Premalignant disease of the epidermis.J Roy Coll Phys Lond 1986;20: 116–21.

    Google Scholar 

  112. MacDonald EJ. The epidemiology of skin cancer.J Invest Dermatol 1959;32: 379–82.

    PubMed  Google Scholar 

  113. Kraemer KH, Lee MM, Scotto J. Xeroderma pigmentosum.Arch Dermatol 1987;123: 241–50.

    PubMed  Google Scholar 

  114. Lehmann AR, Bridges BA. Sunlight-induced cancer: some new aspects and implications of the xeroderma pigmentosum model.Br J Dermatol 1990;122 (Suppl. 35): 115–19.

    Google Scholar 

  115. Bridges BA. Sunlight, DNA damage and skin cancer: a new perspective.Jap J Cancer Res 1990;81: 105–7.

    Google Scholar 

  116. Athas WF, Hedayati MA, Matanoski GM, Farmer ER, Grossman L. Development and field-test validation of an assay for DNA repair in circulating human lymphocytes.Cancer Res 1991;51: 5786–93.

    PubMed  Google Scholar 

  117. Wei Q, Matanoski GM, Farmer ER, Hedayati MA, Grossman L. DNA repair and aging in basal cell carcinoma: a molecular epidemiology study.Proc Natl Acad Sci USA 1993;90: 1614–18.

    PubMed  Google Scholar 

  118. Kromberg JGR, Jenkins T. Prevalence of albinism in the South African Negro.S Afr Med J 1982;61: 383–6.

    PubMed  Google Scholar 

  119. Cervenka J, Witkop CJ, Okoro AN, King RA. Chromosome breaks and sister chromatid exchanges in albinos in Nigeria.Clin Genet 1979;15: 17–21.

    PubMed  Google Scholar 

  120. Luande J, Henschke CI, Mohammed N. The Tanzanian albino skin.Cancer 1985;55: 1823–8.

    PubMed  Google Scholar 

  121. Komberg JGR, Castle D, Zwane EM, Jenkins T. Albinism and skin cancer in Southern Africa.Clin Genet 1989;36: 43–52.

    PubMed  Google Scholar 

  122. Rosenthal FS, West SK, Munoz B, Emmett EA, Strickland PT, Taylor HR. Ocular and facial skin exposure to ultraviolet radiation in sunlight: a personal exposure model with application to a worker population.Health Phys 1991;61: 77–86

    PubMed  Google Scholar 

  123. Vitaliano PP. The use of logistic regression for modelling risk factors: with application to non-melanoma skin cancer.Am J Epidemiol 1978;108: 402–14.

    PubMed  Google Scholar 

  124. Thompson SC, Jolley D, Marks R. Reduction of solar keratoses by regular sunscreen use.New Engl J Med 1993;329: 1147–51.

    PubMed  Google Scholar 

  125. Zaynoun S, Abi Ali L, Shaib J, Kurban A. The relationship of sun exposure and solar elastosis to basal cell carcinoma.J Am Acad Dermatol 1985;12: 522–5.

    PubMed  Google Scholar 

  126. Carey FA, Hogan JM. The relationship of sun exposure and solar elastosis to skin cancer in a high risk population.Irish J Med Sci 1990;159: 44–7.

    PubMed  Google Scholar 

  127. Green A, Siskind V, Bain C. Sunburn and malignant melanoma.Br J Cancer 1985;51: 393–7.

    PubMed  Google Scholar 

Download references

Author information

Author notes

  1. Bruce K. Armstrong

    Present address: Australian Institute of Health and Welfare, Canberra, Australia

Affiliations

  1. International Agency for Research on Cancer, Lyon, France

    Anne Kricker &  Bruce K. Armstrong

  2. Department of Public Health, University of Western Australia, Nealands, WA, Australia

    Dallas R. English

Authors
  1. Anne Kricker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bruce K. Armstrong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dallas R. English
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kricker, A., Armstrong, B.K. & English, D.R. Sun exposure and non-melanocytic skin cancer. Cancer Causes Control 5, 367–392 (1994). https://doi.org/10.1007/BF01804988

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01804988

Key words

  • Descriptive epidemiology
  • epidemiology
  • host factors
  • skin cancer
  • sun exposure