Who is at Risk?

Factors Associated With an Increased Risk of Nonmelanoma Skin Cancer
        Sun and ultraviolet (UV) radiation exposure
Factors Associated With an Increased Risk of Melanoma
        Sun and UV radiation exposure

Note: Separate PDQ summaries on Skin Cancer Screening, Skin Cancer Treatment, and Levels of Evidence for Cancer Screening and Prevention Studies are also available.

Individuals whose skin freckles, tans poorly, or burns easily after sun exposure are particularly susceptible to developing skin cancer.[1] Observational and analytic epidemiologic studies have consistently shown that increased cumulative sun exposure is a risk factor for nonmelanoma skin cancer.[1,2] Organ transplant recipients receiving immunosuppressive drugs are at an elevated risk of skin cancer, particularly squamous cell carcinoma (SCC). Arsenic exposure also increases the risk of cutaneous SCC.[3,4] In the case of melanoma, it seems that intermittent acute sun exposure leading to sunburn is more important than cumulative sun exposure;[5] such exposures during childhood or adolescence may be particularly important.[6] Nonmodifiable host factors, such as a large number of benign melanocytic nevi and atypical nevi may also increase the risk of developing cutaneous melanoma.[6]

Based on solid evidence, sun and ultraviolet radiation exposure are associated with an increased risk of SCC and basal cell carcinoma (BCC).

Magnitude of Effect: Substantial, depending upon amount of exposure.

Study Design: Observational studies.

Internal Validity: Good.

Consistency: Good.

External Validity: Good.

Based on fair evidence, intermittent acute sun exposure leading to sunburn is associated with an increased risk of melanoma.

Magnitude of Effect: Unknown.

Study Design: Observational studies.

Internal Validity: Fair.

Consistency: Fair.

External Validity: Poor.

References

1. Preston DS, Stern RS: Nonmelanoma cancers of the skin. N Engl J Med 327 (23): 1649-62, 1992.  [PUBMED Abstract]
   
   
2. English DR, Armstrong BK, Kricker A, et al.: Case-control study of sun exposure and squamous cell carcinoma of the skin. Int J Cancer 77 (3): 347-53, 1998.  [PUBMED Abstract]
   
   
3. Thomas VD, Aasi SZ, Wilson LD, et al.: Cancer of the skin. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. Vols. 1 & 2. 8th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2008, pp 1863-87. 
   
   
4. Le Mire L, Hollowood K, Gray D, et al.: Melanomas in renal transplant recipients. Br J Dermatol 154 (3): 472-7, 2006.  [PUBMED Abstract]
   
   
5. Gandini S, Sera F, Cattaruzza MS, et al.: Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer 41 (1): 45-60, 2005.  [PUBMED Abstract]
   
   
6. Koh HK: Cutaneous melanoma. N Engl J Med 325 (3): 171-82, 1991.  [PUBMED Abstract]