Environmental Risk Factors for Skin Cancer

  • F. Urbach
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 128)


That chronic exposure to environmental agents can lead to the development of skin cancer in humans has been known for more than 200 years, since Percival Pott described scrotal cancer in chimney sweeps in 1775. Today, the evidence is convincing that the vast majority of skin cancers are due to chronic repeated exposure to solar ultraviolet (UV) radiation. Skin cancers are most prevalent on light complexioned, easily sunburning individuals, and in those who receive the most solar exposure, whether because of occupational or deliberate social reasons. Furthermore, non-melanoma skin cancers occur primarily on sunlight-exposed sites. The recent significant decrease in stratospheric ozone, which increases transmitted short-wavelength UV radiation, has the potential of significantly increasing skin cancer incidence in the future. The dose-response relationships and epidemiologic features of UV-induced skin cancers will be discussed here. Other environmental causes for skin cancer development are exposure to chemicals (polycyclic hydrocarbons derived from the incomplete combustion or distillation of coal or petroleum; inorganic arsenic and photosensitizing agents such as psoralens). In the past, occupational or therapeutic exposure to ionizing radiation has caused skin cancer. Finally, there is some evidence that intense, chronic infrared radiation can enhance the development of skin cancer.


Skin Cancer Natl Cancer Inst Environmental Risk Factor Stratospheric Ozone Total Ozone Column 
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  1. Akasaka T, Kon S (1989) Two cases of squamous cell carcinoma arising from erythema ab igne. Nippon Hifuka Gakkai Zasshi 99: 735–742PubMedGoogle Scholar
  2. Anderson NP, Anderson HE (1951) Development of basal cell epithelioma as a consequence of radiodermatitis. Arch Dermatol Syphilol 63: 586–596CrossRefGoogle Scholar
  3. Arguello RA, Ceuget DD, Tello EE (1938) Cancer y arsenicismo regional éndemico en Cordoba. Rev Argent Dermatosifilol 22: 461–472Google Scholar
  4. Bain JA, Rush HP, Kline BE (1943) Effect of temperature on ultraviolet carcinogenesis with wavelength of 2800–3400 A. Cancer Res 3: 610–612Google Scholar
  5. Bartle EJ, Sun JH, Wang XW, Schneider BK (1990) Cancers arising from burn scars. A literature review and report of twenty-one cases. J Burn Care Rehabil 11: 46–49Google Scholar
  6. Birmingham DJ, Key MM, Holaday DA, Perone VB (1965) An outbreak of arsenical dermatoses in a mining community. Arch Dermatol 91: 457–464PubMedCrossRefGoogle Scholar
  7. Blum HF (1959) Carcinogenesis by ultraviolet light. Princeton University Press, PrincetonGoogle Scholar
  8. Blumthaler M, Ambach W (1988) Solar UVB albedo of various surfaces. Photochem Photobiol 48: 85–88PubMedCrossRefGoogle Scholar
  9. Buettner KJK (1969) The effect of natural sunlight on human skin. In: Urbach F (ed) The biologic effects of ultraviolet radiation. Pergamon, Oxford, pp 237–249Google Scholar
  10. Chuang TY, Popecsh A, Su WPD, Chute CG (1990) Basal cell carcinoma. J Am Acad Dermatol 22: 413–417PubMedCrossRefGoogle Scholar
  11. Cole C, Forbes PD, Davies RE, Urbach F (1985) Effect of indoor lighting on normal skin. In: Wurtman RJ, Baum MJ, Potts JP Jr (eds) The medical and biological effects of light. Ann NY Acad Sci 453:305–316Google Scholar
  12. Cross F (1967) On a turf (peat) fire cancer: malignant change superimposed on erythema ab igne. Proc R Soc Med 60: 1307–1308PubMedGoogle Scholar
  13. Cutler SJ, Young JL (1975) Third National Cancer survey: incidence data. Natl Cancer Inst Monog 41: 75–787Google Scholar
  14. Davies JNP, Tauk R, Meyer R, Thursten P (1968) Cancer of the integumentary system in Ugandan africans. J Natl Cancer Inst 41: 31–51PubMedGoogle Scholar
  15. Davies RE, Dodge HA, Austin Wa (1972) Carcinogenicity of DMBA under various light sources. In: Proceedings of the 6th international congress for photobiology, Bochum (abstr 347)Google Scholar
  16. De Gruijl F (1992) Action spectra for photocarcinogenesis. In: Urbach F (ed) The physiologic effects of UV-A radiation. Valdemar Publishing Co. Overland Park, KS, pp 91–98Google Scholar
  17. Diffey BL (1987) Analysis of the risk of skin cancer from sunlight and solaria in subjects living in northern Europe. Photodermatology 4: 118–126PubMedGoogle Scholar
  18. Doniach I, Mottram JC (1940) On the effect of light upon the incidence of tumors in painted mice. Am J Cancer 39: 234–240Google Scholar
  19. Emmet EA (1973) Ultraviolet radiation as a cause for skin cancer. Crit Rev Toxicol 2: 211–255CrossRefGoogle Scholar
  20. Fierz U (1966) Katamnestische Untersuchungen über die Nebenwirkungen der Therapie der Hautkrankheiten mit anorganischem Arsen. Arch Klin Exp Dermatol 227: 286–290PubMedGoogle Scholar
  21. Findlay GM (1928) Ultraviolet light and skin cancer. Lancet 2: 1070–1073CrossRefGoogle Scholar
  22. Forbes PD, Davies RE (1981) Enhancement of photocarcinogenicity by 8-MOP. In: Cahn J, Forlot P, Grupper C, Maybeck A, Urbach F (eds) Psoralens in cosmetics and dermatology. Pergamon, Oxford, pp 365–370Google Scholar
  23. Fowler I (1786) Medical reports on the effect of arsenic in the cure of agues, remitting fever and periodic headaches. Johnson, LondonGoogle Scholar
  24. Frieben A (1902) Cancroid des rechten Handrückens nach lang dauerden Einwirkung von Roentgenstrahlen. Fortschr Geb Roentgenstr 6: 106–108Google Scholar
  25. Fry RJM (1990) Radiation protection guidelines for the skin. Int J Radiat Biol 57: 829–839PubMedCrossRefGoogle Scholar
  26. Fry RJM, Storer JB, Burns FJ (1986) Radiation induction of cancer of the skin. Br J Radiol Suppl 19: 58–60PubMedGoogle Scholar
  27. Gange RW, Park YK, Kagetsu N, Blackett AD, Parrish JA (1986) Action spectra for cutaneous responses to ultraviolet radiation. In: Urbach F, Gange RW (eds) The biologic effects of UVA radiation. Praeger, New YorkGoogle Scholar
  28. Gellin GA, Kopf AW, Andrade R (1965) Basal cell epitheliomas: a controlled study of associated factors. Arch Dermatol 91: 38–45PubMedCrossRefGoogle Scholar
  29. Geyer L (1898) Über die chronischen Hautveränderungen beim Arsenicismus und Betrachtungen über die Massenerkrankungen in Reichenstein in Schlesien. Arch Dermatol Syphilol 43: 221–280CrossRefGoogle Scholar
  30. Giles GG, Marks R, Foley P (1988) Incidence of non-melanotic skin cancer treated in Australia. BMJ 296: 13–18PubMedCrossRefGoogle Scholar
  31. Glass AG, Hoover RN (1989) The emerging epidemic of melanoma and skin cancer. JAMA 262: 2097–2100PubMedCrossRefGoogle Scholar
  32. Götz H (1976) Tar keratosis. In: Andrade R, Gumport SL, Popkin G, Rees TD (eds) Cancer of the skin. Saunders, Philadelphia, pp 492–523Google Scholar
  33. Green A, Beardmore G, Hart V, Leslie D, Marks R, Staines D (1988) Skin canceer in a Queensland population. J Am Acad Dermatol 19: 1045–1052PubMedCrossRefGoogle Scholar
  34. Grube DD, Ley RD, Fry RJM (1977) Photosensitizing effects of 8-Methoxypsoralen on the skin of hairless mice: II. Strain and spectral differences for tumorigenesis. Photochem Photobiol 25: 269–276Google Scholar
  35. Heller I (1930) Occupational cancers. J Ind Hyg 12: 169–197Google Scholar
  36. Heller W (1950) Experimentelle Untersuchungen über dem Lichtkrebs. Lichtkrebserzeugung durch Photosensibilisierung. Strahlentherapie 81: 529–548PubMedGoogle Scholar
  37. Henseler J (1989) Risk of non-melanoma skin tumors in patients treated with longterm photochemotherapy (PUVA). In: Fitzpatrick TB, Forlot P, Pathak MA, Urbach F (eds) Psoralens. Libbey, London, pp 377–386Google Scholar
  38. Hindmarsh JT, McCurdy RF (1986) Clinical and environmental aspects of arsenic toxicity. Crit Rev Clin Lab Sci 23: 315–347PubMedCrossRefGoogle Scholar
  39. Hueper WC, Payne WW (1960) Carcinogenic studies on petroleum asphalt, cooling oil and coal tar. AMA Arch. Pathol 65: 608–614Google Scholar
  40. Hutchinson J (1888) On some examples of arsenic keratosis of the skin and arsenic cancer. Trans Pathol Soc Lond 39: 352–363Google Scholar
  41. Isaacson C, Selser G, Kaye V et al. (1978) Cancer in urban blacks of South Africa. S African Cancer Bull 22: 49–62Google Scholar
  42. Kligman LH, Kligman AM (1984) Reflections on heat. Br J Dermatol 110:367–375Google Scholar
  43. Koller LR (1965) Ultraviolet radiation. Wiley, New York, p 105Google Scholar
  44. Kricker A, English DR, Randell PL, Heenen PJ, Clay CD, Delaney TA, Armstrong BK (1990) Skin cancer in Geralton, Western Australia: a survey of incidence and prevalence. Med J Aust 152: 399–407PubMedGoogle Scholar
  45. Lawrence EA (1952) Carcinoma arising in scars of thermal burns. Surg Gynecol Obstet 95: 579–588PubMedGoogle Scholar
  46. Lewis MR (1935) The photosensitivity of chick embryo cells growing in media containig certain carcinogenic substances. Am J Cancer 25: 305–309Google Scholar
  47. MacDonald EJ, Bubendorf E (1964) Some epidemiologic aspects of skin cancer. In:Google Scholar
  48. Tumors of the Skin. Yearbook Medical Publishers, Chicago, pp 23–46Google Scholar
  49. Marks R, Ponsford MW, Selwood TS, Goodman G, Mason G (1983) Non-melanotic skin cancer in Victoria. Med J Aust 142: 619–622Google Scholar
  50. Marks R, Jolley D, Dorevitch AP, Selwood TS (1989) The incidence of nonmelanotic skin cancers in an Australian population: results of a five-year prospective study. Med J Aust 150: 475–478PubMedGoogle Scholar
  51. McKinlay AF, Diffey BJ (1987) A reference action spectrum for ultraviolet induced erythema in human skin. In: Passchier WF, Bosnajkovic BFM (eds) Human exposure to ultraviolet radiation: risks and regulations. Exerpta Medica, Amsterdam, pp 83–88Google Scholar
  52. Mottram JC, Doniach I (1938) The photodynamic action of carcinogenic agents. Lancet 1: 1156–1159CrossRefGoogle Scholar
  53. Mulay DM (1963) Skin cancer in India. In: Urbach F (ed) The biology of cutaneous cancer. Natl Cancer Inst Monogr 10: 215–224Google Scholar
  54. O’Beirn SF, Judge P, Urbach F, MacCon CF, Martin F (1970) Skin cancer in County Galway. In: Proceedings of the 6th national cancer conference. Lippincott, Philadelphia, pp 489–500Google Scholar
  55. Oettle AC (1963) Skin cancer in Africa. In: Urbach F (ed) The biology of cutaneous cancer. Natl Cancer Inst Monogr 10: 197–214Google Scholar
  56. Owen DW, Knox JM (1978) Influence of heat, wind and humidity on ultraviolet radiation injury. Natl Cancer Inst Monogr 50: 161–167Google Scholar
  57. Parrish JA, Fitzpatrick TB, Tanenbaum L et al. (1974) Photochemotherapy of psoriasis with oral methoxsalen and long-wave ultraviolet light. N Engl J Med 291: 1207–1211PubMedCrossRefGoogle Scholar
  58. Pott P (1775) Chirurgical observations relative to cataract, the nose, the cancer of the scrotum, the different kinds of ruptures, and the mortification of the toes and feet. Hower, Clarke and Pollius, London, 63Google Scholar
  59. Potten CS (1985) Radiation and skin. Taylor and Francis, LondonGoogle Scholar
  60. Roth F (1956) Über die chronische Arsenvergiftung der Moselwinzer unter besonderer Berücksichtigung des Arsenkrebses. Z Krebsforsch 61: 287–319PubMedCrossRefGoogle Scholar
  61. Sanderson KV (1976) Arsenic and skin cancer. In: Andrade R, Gumport SL, Popkin GL, Rees TD (eds) Cancer of the skin. Saunders, Philadelphia, pp 473–491Google Scholar
  62. Schulze R (1970) Das Strahlenklima der Erde. Steinkoppf, DarmstadtGoogle Scholar
  63. Scotto J, Fears RR, Fraumeni JF Jr (1981) Incidence of non-melanoma skin cancer in the United States. Publ No (NIH) 82–2433. National Cancer Institute, BethesdaGoogle Scholar
  64. Scotto J, Cotton G, Urbach F, Berger D, Fears T (1988) Biologically effective ultraviolet radiation: Surface measurements in the United States 1974–1985. Science 239: 762–764PubMedCrossRefGoogle Scholar
  65. Silverstone H, Searle JHA (1970) The epidemiology of skin cancer in Queensland. Br J Cancer 24: 235–253PubMedCrossRefGoogle Scholar
  66. Stern RS (1989) PUVA: its status in the United States 1988. In: Fitzpatrick TBGoogle Scholar
  67. Forlot P, Pathak MA, Urbach F (eds) Psoralens. Libbey, London, pp 367–376Google Scholar
  68. Stern RS, Thibodeau LA, Kleinerman RA, Parrish JA, Fitzpatrick TB (1979) Risk of cutaneous carcinoma in patients treated with oral methoxsalen photochemotherapy for psoriasis. N Engl J Med 300: 809–813PubMedCrossRefGoogle Scholar
  69. Thiers H, Colomb D, Moulin G, Cohn L (1967) Le cancer cutané arsénical des viticulteurs du Beaujolais. Ann Dermatol Syphilogr 94: 133–158Google Scholar
  70. Traenkle HL (1963) X-ray induced skin cancer in man. In: Urbach F (ed) The biology of cutaneous cancer. Natl Cancer Inst Monogr 10: 423–432Google Scholar
  71. Urbach F (1969) The geographic pathology of skin cancer. In: Urbach F (ed) The biologic effects of ultraviolet radiation. Pergamon, Oxford, pp 635–650Google Scholar
  72. Urbach F, Rose BB, Bonnem M (1972) Genetic and environmental interactions in skin carcinogenesis. In: Environmental cancer. Williams and Wilkins, Baltimore, pp 353–371Google Scholar
  73. Veiel F (1924) Teerkrebs beim Menschen. Arch Dermatol Res 148:142–145 Vitaliano PP, Urbach F (1980) The relative importance of risk factors in non-melanoma carcinoma. Arch Dermatol 116: 454–456Google Scholar
  74. Volkman R (1875) Über Teer, Parraffin und Rubkrebs (Schornsteinfeger Krebs). In: Volkman R (ed) Beiträge zur Chirurgie. Breitkopf, Leipzig, p 370Google Scholar
  75. Watson RT, Ozone Trends Panel (1988) Present state of knowledge of the upper atmosphere 1988. An assessment report. NASA reference publication 1208. NASA, WashingtonGoogle Scholar
  76. Yamagiwa K, Itchikawa K (1918) Experimental study of the pathogenesis of carcinoma. J Cancer Res 3: 1–12Google Scholar
  77. Yeh S (1973) Skin cancer in chronic arsenicism. Hum Pathol 4: 469–485PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1993

Authors and Affiliations

  • F. Urbach
    • 1
  1. 1.Temple Medical PracticesFort WashingtonUSA

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