Article
Occupational exposure to UV radiation and skin cancer – the use of cancer registry data in epidemiologic research
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Published: | March 20, 2006 |
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Aims: To illustrate the possibilities and limitations of epidemiologic research based on cancer-registry data, the association between occupational exposure to UV radiation and skin cancer (squamous cell cancer and melanoma) is analyzed on the basis of cancer registry data.
Methods: As a first case group, 2.901 male patients with squamous cell carcinoma of the skin diagnosed between 1998 and 2003 were compared with 14.335 male patients with prostate cancer. As a second case group, 1.717 male patients with malignant melanoma were compared with 14.388 patients with prostate cancer. Male patients suffering simultaneously from skin cancer and prostate cancer were regarded as “cases”. Age-adjusted odds ratios and 95% confidence intervals were calculated for outdoor occupations (construction workers, wine-growers, farmers, gardeners, and forestry workers) versus white-collar or production workers (excluding outdoor workers) using logistic regression analysis.
Results: Significantly elevated risks of squamous cell cancer of the skin were found among farmers (odds ratio OR=1.8; 95% confidence interval CI 1.3-2.6), wine-growers (OR=2.2; 95% CI 1.4-3.5), and construction workers (OR=1.7; 95% CI 1.3-2.1). For malignant melanoma, no elevated risks could be found among potentially UV-exposed occupational groups.
Discussion and conclusions: In accordance with the literature, the analysis of cancer registry data revealed significantly elevated risks of squamous cell cancer of the skin among men occupationally exposed to UV radiation. The main limitation of the study lies in the low completeness of occupational data: In the Rheinland-Pfalz cancer registry, data were missing for 54% of the skin cancer patients and for 67% of the prostate cancer patients. Moreover, intensity and duration of occupational exposure to UV radiation was unknown for cancer registry patients. However, currently more than 95% of all incident skin cancer patients are reported to the Rheinland-Pfalz cancer registry. Therefore, to further clarify the association between occupational as well as non-occupational factors (e.g., leisure time UV exposure, dietary factors, BCG-vaccination) and skin cancer, cancer-registry data might serve as a basis for future analytic epidemiologic studies.