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Christian James Pompoco, Chase Paulson, Samuel C. Taylor, Brian Craig Stagg, Robert Ritch, Jae H Kang, Janey L Wiggs, Louis R Pasquale, Karen Curtin, Barbara M Wirostko; Association of Non-Melanoma Skin Cancer with Exfoliation Syndrome: The Utah Project of Exfoliation Syndrome. Invest. Ophthalmol. Vis. Sci. 2021;62(8):71.
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© ARVO (1962-2015); The Authors (2016-present)
The Utah Project on Exfoliation Syndrome (UPXFS) was created to investigate the association between systemic disorders and exfoliation syndrome (XFS). Given the data suggesting an association between non-melanoma skin cancer (NMSC), i.e. basal and squamous cell cancer (cancers most often located in areas of sun exposure) and XFS based on the ocular UV exposure hypothesis, a retrospective cohort study was conducted to evaluate the relationship between NMSC and XFS.
NMSC and malignant melanoma diagnoses (based on ICD-O-3 and ICD-9/10 codes) were obtained from the Utah Cancer Registry (UCR) and University of Utah Healthcare (UUHC) patient records from 1966-2016 and linked to individuals in the Utah Population Database (UPDB) with XFS and without XFS. The occurrence of a melanoma or basal/squamous cell skin cancer diagnosis was estimated in 2,659 XFS patients compared with randomly selected 13,294 participants without XFS in the population matched 1:5 on sex and birth year using a logistic regression model accounting for sex and age from individual matching and adjusting for race and ethnicity.
Among the 2,659 XFS cases, the mean age of XFS diagnosis was 74 years, and 67% were women. Of the 2,659 XFS patients and the 13,294 individuals without XFS, 227 patients (8.5%) and 829 (6.2%) without XFS were diagnosed with basal or squamous cell skin cancer respectively. Compared with those without XFS, in those with XFS, there was an approximate 1.5-fold increased risk of basal or squamous cell skin cancers (odds ratio of 1.46, 95% confidence interval: 1.25-1.71; p<0.0001). We observed no association between XFS and malignant melanoma.
XFS is a systemic disorder related to elastosis, and this data suggests that individuals with XFS may have an increased risk of a NMSC history. These data are consistent with the findings from another study that reported an association between those with NMSC and incident XFS7. We hypothesize based on these findings that an underlying pathogenesis of NMSC and XFS may stem from a common triggering event – ultraviolet exposure.
This is a 2021 ARVO Annual Meeting abstract.
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