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A risk factor
is anything that affects your chance of getting a disease such as
cancer. Different cancers have different risk factors. For example,
unprotected exposure to strong sunlight is a risk factor for skin
cancer, and smoking is a risk factor for cancers of the lung, mouth,
throat, kidneys, bladder, and several other organs.
But risk factors don't tell us everything. Having a risk
factor, or even several risk factors, does not mean that you will get
the disease. And many people who get the disease may not have had any
known risk factors. Even if a person with basal or squamous cell skin
cancer has a risk factor, it is often very hard to know how much that
risk factor may have contributed to the cancer.
The following are known risk factors for basal cell and
squamous cell carcinomas (but do not apply to other forms of
non-melanoma skin cancer such as Kaposi sarcoma and cutaneous
lymphoma).
Ultraviolet (UV) light exposure
Ultraviolet (UV) radiation is thought to be the major risk
factor for most skin cancers. Sunlight is the main source of UV
radiation, which can damage the genes in your skin cells. Tanning lamps
and booths are another source of UV radiation. People with excessive
exposure to light from these sources are at greater risk for skin
cancer.
The amount of UV exposure depends on the intensity of the
radiation, length of time the skin was exposed, and whether the skin
was protected with clothing and sunscreen. Many studies also point to
exposure at a young age as an added risk factor.
Ultraviolet radiation is divided into 3 wavelength ranges:
- UVA rays
are involved in the aging of cells and cause some damage to cells' DNA.
They are mainly linked to long-term skin damage such as wrinkles, but
are also thought to play a role in some skin cancers.
- UVB rays
are mainly responsible for direct damage to the DNA, and are the rays
that primarily cause sunburns. They are also thought to cause most skin
cancers.
- UVC rays
don't penetrate our atmosphere and therefore are not present in
sunlight. They are not normally a risk factor for skin cancer.
While UVA and UVB rays make up only a very small portion of
the sun's wavelengths, they are mainly responsible for the damaging
effects of the sun on the skin. UVB radiation damages the DNA of skin
cells. Skin cancers begin when this damage affects the DNA of genes
that control skin cell growth. Recent research has found that UVA also
contributes to skin cancer formation. Scientists now believe that both
UVA and UVB rays damage skin and cause skin cancer. UVB rays are a more
potent cause of at least some skin cancers, but there are no safe UV rays.
People who live in areas with year-round, bright sunlight have
a higher risk. For example, the risk of skin cancer is twice as high in
Arizona compared to Minnesota. The highest rate of skin cancer in the
world is in Australia. Spending a lot of time outdoors for work or
recreation without protective clothing and sunscreen increases your
risk.
Having fair skin
The risk of skin cancer is much higher for whites than for
African Americans or Hispanics. This is due to the protective effect of
melanin (skin pigment). Whites with fair (light-colored) skin that
freckles or burns easily are at especially high risk. This is another
reason for the high skin cancer rate in Australia, as the major
settlers were fair-skinned immigrants from the British Isles.
Albinism is a congenital (present at birth) absence of skin
pigment. People with this condition may have pink-white skin and white
hair. They have a high risk of getting skin cancer unless they are
careful to protect their skin.
Older age
The risk of basal and squamous cell skin cancers grows as
people get older. This is likely due to the accumulation of sun
exposure over time. Still, these cancers are now being seen in younger
people as well, probably because they are spending more time in the sun
with their skin exposed.
Male gender
Men are about 2 times as likely as women to have basal cell
cancers and about 3 times as likely to have squamous cell cancers of
the skin. This is thought to be due mainly to higher levels of sun
exposure.
Exposure to certain chemicals
Exposure to
large amounts of arsenic increases the risk of developing skin cancer.
Arsenic is a heavy metal found naturally in well water in some areas.
It is also used in making some pesticides and certain medicines.
Workers exposed to industrial tar, coal, paraffin, and certain types of
oil may also have an increased risk for non-melanoma skin cancer.
Radiation exposure
People who have had radiation treatment have a higher risk of
developing skin cancer in the area that received the treatment. This is
particularly a problem in children who have had cancer treatment.
Almost all of these cancers are basal cell carcinomas.
Previous skin cancer
Anyone who has had a skin cancer has a much higher chance of
developing another one.
Long-term or severe skin inflammation or
injury
Scars from severe burns, areas of skin over severe bone
infections, and skin damaged by some severe inflammatory skin diseases
are more likely to develop keratinocyte skin cancers, although this
risk is generally small.
Psoriasis treatment
Psoralen and ultraviolet light treatments (PUVA) given to some
patients with psoriasis (a long-lasting inflammatory skin disease) can
increase the risk of developing squamous cell skin cancer and probably
other skin cancers also.
Xeroderma pigmentosum (XP)
This very rare inherited condition reduces the skin's ability
to repair damage to DNA caused by sun exposure. People with this
disorder often develop many skin cancers, sometimes starting in
childhood.
Basal cell nevus syndrome
This rare congenital (present at birth) condition causes
multiple basal cell cancers. Most, but not all, cases are inherited.
Affected people may also have abnormalities of the jaw and other bones,
eyes, and nervous tissue. One clue to having this syndrome in your
family is if the affected person began developing basal cell cancers
when he or she was young (for example, under age 20).
Reduced immunity
The immune system helps the body fight cancers of the skin and
other organs. People with weakened immune systems (due to certain
diseases or medical treatments) are more likely to develop non-melanoma
skin cancer, particularly squamous cell cancer.
For example, organ transplant patients are usually given
medicines that weaken their immune system to prevent their body from
rejecting the new organ. This increases their risk of developing skin
cancer. The rate of skin cancer in people who have had transplants can
be as high as 80% within 20 years after the transplant. Skin cancers in
people with weakened immune systems grow faster and are more likely to
be fatal.
Treatment with corticosteroid drugs can also depress the
immune system. This may also increase a person's risk of skin cancer.
Human papilloma virus (HPV) infection
Human papilloma viruses (HPVs) are a group of more than 100
viruses that can cause papillomas, or warts. The types of warts that
people commonly get on their hands and feet appear to be unrelated to
any form of cancer. But some of the HPV types that people get in their
genital and anal area appear to be related to skin cancers in these
areas.
Smoking
People who smoke are more likely to develop squamous cell skin
cancer, especially on the lips. Smoking is not a risk factor for basal
cell cancer.
Genetic susceptibility
Scientists have found that certain people are more likely to
develop (susceptibility) skin cancer than others after sun exposure. In
these people, the chromosomes are more sensitive to being damaged by
sunlight.
Last Revised: 06/10/2008
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