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    High versus low sun protection factor sunscreens and cutaneous squamous cell carcinoma risk: a population-based cohort study

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    Authors
    Lergenmuller, S.
    Ghiasvand, R.
    Robsahm, T. E.
    Green, Adèle C
    Lund, E.
    Rueegg, C. S
    Veierød, M. B.
    Affiliation
    Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
    Issue Date
    2021
    
    Metadata
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    Abstract
    Evidence on sunscreen use and cutaneous squamous cell carcinoma (cSCC) risk is limited. Most studies did not take sun protection factor (SPF) into consideration, and used nonusers of sunscreen as the reference group. Nonusers are likely a priori at lower cSCC risk than users. No study has investigated the effect of high versus low SPF sunscreens on cSCC appropriately adjusting for time-varying confounding. Using data from the Norwegian Women and Cancer study (1991-2016), we investigated whether use of SPF≥15+ versus SPF<15+ sunscreens reduces cSCC risk. We used marginal structural Cox proportional hazards model with inverse probability of treatment and censoring weights to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During follow-up of 148,781 women (1991-2016, mean 14.3 years), 653 women were diagnosed with cSCC. The effect on cSCC risk of SPF≥15+ versus SPF<15+ sunscreens was close to the null when used at any latitudes (HR=1.02, 95% CI: 0.82, 1.27) and when used in lower latitude settings (HR=1.05, 95% CI: 0.84, 1.32). In conclusion, we found no indication that SPF≥15+ sunscreens reduced Norwegian women's cSCC risk more than SPF<15+ sunscreens, suggesting that either there is no difference in their effects long-term, or the difference is diluted by incorrect application.
    Citation
    Lergenmuller S, Ghiasvand R, Robsahm TE, Green AC, Lund E, Rueegg CS, et al. High Versus Low Sun Protection Factor Sunscreens and Cutaneous Squamous Cell Carcinoma Risk: A Population-Based Cohort Study. American Journal of Epidemiology. 2021 Aug 11.
    Journal
    American Journal of Epidemiology
    URI
    http://hdl.handle.net/10541/624557
    DOI
    10.1093/aje/kwab216
    PubMed ID
    34379745
    Additional Links
    https://dx.doi.org/10.1093/aje/kwab216
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1093/aje/kwab216
    Scopus Count
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    All Paterson Institute for Cancer Research

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