The relationship between UV exposure and incidence of skin cancer

BACKGROUND: The incidence rates of skin cancer increase with decreasing latitude in most western countries. Ultraviolet (UV) radiation is a main risk factor for skin cancer. METHODS: We have studied the relationship between UV exposure and skin cancer incidence rates of squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and cutaneous melanoma (CM), and tried to fit different mathematical models to the experimental data. RESULTS: The incidence-UV exposure relationship for all three cancers is best described by the power law: ln(RTD) = Ab ·ln(annual UVEry dose), with relative tumor density (RTD) being age-adjusted incidence rate per unit area of skin, and the power parameter Ab being the biological amplification factor. For SCC, the RTD is a factor of 16-19 times larger on the head than on the trunk. For BCC, this factor is 7 and for CM it is 0.9-1.3. Ab for CM has remained almost unchanged from the 1960s until recently. CONCLUSIONS: The incidence-sun exposure relationship for all three cancers is well described by the power law. SCC is dependent on total UV exposures, while BCC, and even more CM, is dependent also on exposure patterns, with intermittent exposures being most carcinogenic.