BACKGROUND Basal cell carcinoma of the skin (BCC) is the most common cancer in populations of European ancestry. Although consistently linked with basal cell carcinoma of the skin in case-control studies, few prospective cohort studies have evaluated the shape of the exposure-response of basal cell carcinoma associated with cumulative radiant solar ultraviolet exposure (UVR). METHODS We followed 63,912 white cancer-free US radiologic technologists from entry (1983-1998) to exit (2003-2005) with known ultraviolet irradiance at up to 5 residential locations. Using generalized-additive and relative risk models we analyzed the exposure-response of basal cell carcinomas associated with ambient cumulative ultraviolet radiant exposure using ground-based National Solar Radiation database Average Daily Total Global data and satellite-based National Aeronautics and Space Administration Total Ozone Mapping Spectrometer data. RESULTS There were 2151 technologists with an incident primary basal cell carcinoma. Risk of basal cell carcinoma rose with increasing cumulative ultraviolet radiation exposure using both measures, such that 1 MJ cm- 2 increased basal cell carcinoma risk by 8.48 (95% CI 5.22, 11.09, p < 0.001) and by 10.15 (95% CI 6.67, 13.10, p < 0.001) per 10,000 persons per year using the Average Daily Total Global and Total Ozone Mapping Spectrometer ultraviolet data, respectively; relative risk was likewise elevated. There was some evidence of upward curvature in the cumulative ultraviolet exposure response using both exposure measures with a greater increase in risk of basal cell carcinoma at higher levels of ultraviolet radiation exposure, but less evidence for curvature in relative risk. There are indications of substantial variation of relative risk with time after exposure and age at exposure, so that risk is highest for the period 10-14 years after ultraviolet radiation exposure and for those exposed under the age of 25. CONCLUSIONS We observed increases in risk of basal cell carcinoma and a similar exposure-response for ground-based and satellite ultraviolet radiation measures. Our observations suggest that interventions should concentrate on persons with higher levels of ultraviolet radiation exposure.

中文翻译：

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使用卫星和地面测量，在美国全国范围内进行的累积太阳紫外线辐射暴露和皮肤基底细胞癌的研究。

背景技术皮肤基底细胞癌（BCC）是欧洲血统人群中最常见的癌症。尽管在病例对照研究中始终与皮肤基底细胞癌相关，但很少有前瞻性队列研究评估与累积辐射太阳紫外线暴露（UVR）相关的基底细胞癌暴露反应的形状。方法我们追踪了63,912名美国白人无放射线放射技术人员，从入院（1983-1998）到出院（2003-2005），他们在多达5个居民区使用已知的紫外线辐照度。使用广义的加性和相对风险模型，我们使用了基于地面的国家太阳辐射数据库，分析了与环境累积紫外线辐射暴露相关的基底细胞癌的暴露反应，该研究使用的是全球每日平均总数据和基于卫星的美国国家航空航天局总臭氧图。光谱仪数据。结果有2151名技术人员发生了原发性基底细胞癌。使用这两种方法，随着累积紫外线暴露量的增加，基底细胞癌的风险也随之增加，因此1 MJ cm-2会使基底细胞癌的风险增加8.48（95％CI 5.22，11.09，p <0.001）和10.15（95％CI 6.67） ，分别使用全球平均每日总臭氧光谱仪和总臭氧作图光谱仪的紫外线数据，每10,000人每年，13.10，p <0.001）；相对风险也同样升高。有两种证据表明，在使用两种暴露措施的情况下，累积紫外线暴露响应均会出现向上弯曲，在较高水平的紫外线辐射下，基底细胞癌的风险增加幅度更大，但相对风险发生弯曲的证据则较少。有迹象表明，相对风险随暴露时间和暴露年龄的变化而变化，因此暴露于紫外线辐射后10-14年以及25岁以下者的风险最高。结论我们观察到风险增加对基底细胞癌的诊断，以及对地面和卫星紫外线辐射措施的类似暴露响应。我们的观察结果表明，干预措施应针对紫外线辐射水平较高的人群。