Article publication date:
May 2022
Authored by:
Elysha Kolitz et al
Summary
This systematic review examined the relationship between ultraviolet (UV) radiation exposure and keratinocyte carcinoma (also known as non-melanoma skin cancer) in people with a Fitzpatrick skin type of 4 to 6 and those who rarely experience sun burn and tan easily. UV index based on location, history of phototherapy, history of sunburn and occupational UV exposure were used as measures of exposure. The review screened 29,393 unique articles. Of those 454 articles were assessed by full text with 12 meeting the eligibility criteria and were included into the review. Of the included studies, 11 were conducted on East Asian populations with the remaining study conducted in Chile, and there was 1 ecological study, 2 case-control studies and 9 cohort studies. There were no associations reported between keratinocyte carcinoma and phototherapy exposure in 8 of the studies on East Asian populations. However, the other 4 studies reported an association between keratinocyte carcinoma and UV exposure based on location, occupation, and cumulative sun exposure. The authors also reported that the studies assessed in this review were of low to medium quality.
Link to:
UV Exposure and the Risk of Keratinocyte Carcinoma in Skin of Color: A Systematic Review
Published in:
JAMA Dermatology
Commentary by ARPANSA:
The result from this study suggested that people of darker skin colour are at risk of skin cancers from outdoor jobs, living at lower latitudes, and greater cumulative sun exposure. This is in line with the advice of the Cancer Council and ARPANSA that recommends that all people in Australia should limit their UV exposure and use a combination of sun protection measures (e.g., clothing and sunglasses, shade and sunscreen). For more information see the ARPANSA factsheet, Sun exposure and health.
The study also reported that phototherapy is not a risk factor for keratinocyte carcinoma in darker skinned people. Other epidemiological studies have also shown no increased risk of skin cancer from phototherapy (Hearn et al 2008, Jeong Ju et al 2021). However, the narrow band UVB that is used in phototherapy has the energy levels to cause DNA damage and in turn cause skin cancer. It is likely that previous studies have not been large enough to identify the small increased risk of skin cancer that these treatments may cause (Hearn et al 2008). This is likely true for everyone regardless of their skin type. Phototherapy medical treatment for people with skin conditions if performed in consultation with a doctor is beneficial and would not inordinately increase a person’s risk of skin cancer.
