Ambient temperature and risk of first primary basal cell carcinoma: A nationwide United States cohort study

D. Michal Freedman, Cari M. Kitahara, Martha S. Linet, Bruce H. Alexander, Gila Neta, Mark P. Little, Elizabeth K. Cahoon

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


The Earth's surface is warming and animal studies have shown higher temperatures promote ultraviolet radiation (UVR) skin carcinogenesis. There are, however, no population studies of long-term temperature exposure and basal cell carcinoma (BCC) risk. We linked average lifetime summer ambient temperatures (based on weather station data) and satellite-based UVR estimates to self-reported lifetime residences in the U.S. Radiologic Technologists' cohort. We assessed the relationship between time-dependent average lifetime summer ambient temperature (20-year lag) in quintiles and BCC in whites, using Cox proportional hazards regression. Risks were adjusted for time-dependent lagged average lifetime UVR and time outdoors, body mass index, eye color, and sex (baseline hazard stratified on birth cohort). During a median 19.4 years follow-up, we identified 3556 BCC cases. There was no significant trend in risk between temperature and BCC. However, BCC risk was highest in the fourth quintile of temperature (Q4 vs. Q1; hazards ratio (HR) = 1.18; 95% confidence interval (CI) = 1.06-1.31, p-trend = 0.09). BCC risk was strongly related to average lifetime ambient UVR exposure (Q5 vs. Q1; HR = 1.54 (95% CI = 1.35-1.75, p-trend = <0.001)). Future studies of temperature and BCC risk should include a broad range of UVR and temperature values, along with improved indicators of exposure to temperatures and UVR.

Original languageEnglish (US)
Pages (from-to)284-289
Number of pages6
JournalJournal of Photochemistry and Photobiology B: Biology
StatePublished - Jul 1 2015


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