Radiation-related risk of basal cell carcinoma

A report from the childhood cancer survivor study

Tanya C. Watt, Peter D. Inskip, Kayla Stratton, Susan A. Smith, Stephen F. Kry, Alice J. Sigurdson, Marilyn Stovall, Wendy Leisenring, Leslie L. Robison, Ann C. Mertens

Research output: Contribution to journalArticle

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Abstract

Background Basal cell carcinoma (BCC) is the most common malignancy in the United States. Ionizing radiation is an established risk factor in certain populations, including cancer survivors. We quantified the association between ionizing radiation dose and the risk of BCC in childhood cancer survivors. Methods Participants in the Childhood Cancer Survivor Study who reported a BCC (case subjects, n = 199) were matched on age and length of follow-up to three study participants who had not developed a BCC (control subjects, n = 597). The radiation-absorbed dose (in Gy) to the BCC location was calculated based on individual radiotherapy records using a custom-designed dosimetry program. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between demographic and treatment factors, therapeutic radiation dose, and surrogate markers of sun sensitivity (skin and hair color) and the risk of BCC. A linear doseresponse model was fitted to evaluate the excess odds ratio per Gy of radiation dose. Results Among case subjects, 83% developed BCC between the ages of 20 and 39 years. Radiation therapy, either alone or in combination with chemotherapy, was associated with an increased risk of BCC compared with no chemotherapy or radiation. The odds ratio for subjects who received 35 Gy or more to the skin site vs no radiation therapy was 39.8 (95% CI = 8.6 to 185). Results were consistent with a linear doseresponse relationship, with an excess odds ratio per Gy of 1.09 (95% CI = 0.49 to 2.64). No other treatment variables were statistically significantly associated with an increased risk of BCC. Conclusions Radiation doses to the skin of more than 1 Gy are associated with an increased risk of BCC.

Original languageEnglish (US)
Pages (from-to)1240-1250
Number of pages11
JournalJournal of the National Cancer Institute
Volume104
Issue number16
DOIs
StatePublished - Aug 2012

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Basal Cell Carcinoma
Survivors
Radiation
Neoplasms
Odds Ratio
Radiotherapy
Confidence Intervals
Ionizing Radiation
Hair Color
Skin Pigmentation
Radiation Dosage
Skin
Solar System
Combination Drug Therapy
Linear Models
Therapeutics
Biomarkers
Logistic Models
Demography
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Watt, T. C., Inskip, P. D., Stratton, K., Smith, S. A., Kry, S. F., Sigurdson, A. J., ... Mertens, A. C. (2012). Radiation-related risk of basal cell carcinoma: A report from the childhood cancer survivor study. Journal of the National Cancer Institute, 104(16), 1240-1250. https://doi.org/10.1093/jnci/djs298

Radiation-related risk of basal cell carcinoma : A report from the childhood cancer survivor study. / Watt, Tanya C.; Inskip, Peter D.; Stratton, Kayla; Smith, Susan A.; Kry, Stephen F.; Sigurdson, Alice J.; Stovall, Marilyn; Leisenring, Wendy; Robison, Leslie L.; Mertens, Ann C.

In: Journal of the National Cancer Institute, Vol. 104, No. 16, 08.2012, p. 1240-1250.

Research output: Contribution to journalArticle

Watt, TC, Inskip, PD, Stratton, K, Smith, SA, Kry, SF, Sigurdson, AJ, Stovall, M, Leisenring, W, Robison, LL & Mertens, AC 2012, 'Radiation-related risk of basal cell carcinoma: A report from the childhood cancer survivor study', Journal of the National Cancer Institute, vol. 104, no. 16, pp. 1240-1250. https://doi.org/10.1093/jnci/djs298
Watt, Tanya C. ; Inskip, Peter D. ; Stratton, Kayla ; Smith, Susan A. ; Kry, Stephen F. ; Sigurdson, Alice J. ; Stovall, Marilyn ; Leisenring, Wendy ; Robison, Leslie L. ; Mertens, Ann C. / Radiation-related risk of basal cell carcinoma : A report from the childhood cancer survivor study. In: Journal of the National Cancer Institute. 2012 ; Vol. 104, No. 16. pp. 1240-1250.
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abstract = "Background Basal cell carcinoma (BCC) is the most common malignancy in the United States. Ionizing radiation is an established risk factor in certain populations, including cancer survivors. We quantified the association between ionizing radiation dose and the risk of BCC in childhood cancer survivors. Methods Participants in the Childhood Cancer Survivor Study who reported a BCC (case subjects, n = 199) were matched on age and length of follow-up to three study participants who had not developed a BCC (control subjects, n = 597). The radiation-absorbed dose (in Gy) to the BCC location was calculated based on individual radiotherapy records using a custom-designed dosimetry program. Conditional logistic regression was used to calculate odds ratios (ORs) and 95{\%} confidence intervals (CIs) for associations between demographic and treatment factors, therapeutic radiation dose, and surrogate markers of sun sensitivity (skin and hair color) and the risk of BCC. A linear doseresponse model was fitted to evaluate the excess odds ratio per Gy of radiation dose. Results Among case subjects, 83{\%} developed BCC between the ages of 20 and 39 years. Radiation therapy, either alone or in combination with chemotherapy, was associated with an increased risk of BCC compared with no chemotherapy or radiation. The odds ratio for subjects who received 35 Gy or more to the skin site vs no radiation therapy was 39.8 (95{\%} CI = 8.6 to 185). Results were consistent with a linear doseresponse relationship, with an excess odds ratio per Gy of 1.09 (95{\%} CI = 0.49 to 2.64). No other treatment variables were statistically significantly associated with an increased risk of BCC. Conclusions Radiation doses to the skin of more than 1 Gy are associated with an increased risk of BCC.",
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T2 - A report from the childhood cancer survivor study

AU - Watt, Tanya C.

AU - Inskip, Peter D.

AU - Stratton, Kayla

AU - Smith, Susan A.

AU - Kry, Stephen F.

AU - Sigurdson, Alice J.

AU - Stovall, Marilyn

AU - Leisenring, Wendy

AU - Robison, Leslie L.

AU - Mertens, Ann C.

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N2 - Background Basal cell carcinoma (BCC) is the most common malignancy in the United States. Ionizing radiation is an established risk factor in certain populations, including cancer survivors. We quantified the association between ionizing radiation dose and the risk of BCC in childhood cancer survivors. Methods Participants in the Childhood Cancer Survivor Study who reported a BCC (case subjects, n = 199) were matched on age and length of follow-up to three study participants who had not developed a BCC (control subjects, n = 597). The radiation-absorbed dose (in Gy) to the BCC location was calculated based on individual radiotherapy records using a custom-designed dosimetry program. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between demographic and treatment factors, therapeutic radiation dose, and surrogate markers of sun sensitivity (skin and hair color) and the risk of BCC. A linear doseresponse model was fitted to evaluate the excess odds ratio per Gy of radiation dose. Results Among case subjects, 83% developed BCC between the ages of 20 and 39 years. Radiation therapy, either alone or in combination with chemotherapy, was associated with an increased risk of BCC compared with no chemotherapy or radiation. The odds ratio for subjects who received 35 Gy or more to the skin site vs no radiation therapy was 39.8 (95% CI = 8.6 to 185). Results were consistent with a linear doseresponse relationship, with an excess odds ratio per Gy of 1.09 (95% CI = 0.49 to 2.64). No other treatment variables were statistically significantly associated with an increased risk of BCC. Conclusions Radiation doses to the skin of more than 1 Gy are associated with an increased risk of BCC.

AB - Background Basal cell carcinoma (BCC) is the most common malignancy in the United States. Ionizing radiation is an established risk factor in certain populations, including cancer survivors. We quantified the association between ionizing radiation dose and the risk of BCC in childhood cancer survivors. Methods Participants in the Childhood Cancer Survivor Study who reported a BCC (case subjects, n = 199) were matched on age and length of follow-up to three study participants who had not developed a BCC (control subjects, n = 597). The radiation-absorbed dose (in Gy) to the BCC location was calculated based on individual radiotherapy records using a custom-designed dosimetry program. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between demographic and treatment factors, therapeutic radiation dose, and surrogate markers of sun sensitivity (skin and hair color) and the risk of BCC. A linear doseresponse model was fitted to evaluate the excess odds ratio per Gy of radiation dose. Results Among case subjects, 83% developed BCC between the ages of 20 and 39 years. Radiation therapy, either alone or in combination with chemotherapy, was associated with an increased risk of BCC compared with no chemotherapy or radiation. The odds ratio for subjects who received 35 Gy or more to the skin site vs no radiation therapy was 39.8 (95% CI = 8.6 to 185). Results were consistent with a linear doseresponse relationship, with an excess odds ratio per Gy of 1.09 (95% CI = 0.49 to 2.64). No other treatment variables were statistically significantly associated with an increased risk of BCC. Conclusions Radiation doses to the skin of more than 1 Gy are associated with an increased risk of BCC.

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