Abstract
Most of the epidemiology studies on the effects of sun exposure and prostate cancer were conducted among the temperate countries of North America and Europe. Little is known about the influence on Asian populations. The purpose of current study was to evaluate any association of sun exposure with risk of prostate cancer in Chinese, Malays and Indians who reside in the tropics. The Singapore Prostate Cancer Study is a hospital-based case-control study of 240 prostate cancer incident cases and 268 controls conducted in Singapore between April 2007 and May 2009. Detailed information on outdoor activities in the sun, skin colour, sun sensitivity and other possible risk factors were collected in personal interviews. Cases were further classified by Gleason scores and TNM staging. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis, adjusted for age, ethnicity, education, family history of any cancers, BMI and skin colour. We found that prostate cancer risk was increased in subjects with black/dark-brown eyes (OR 5.88, 95%CI 3.17-10.9), darker skin colour e.g. tan/dark brown/black (OR 7.62, 95%CI 3.41-17.0), frequent sunburn in lifetime (OR 4.30, 95%CI 1.7-11.2) and increased general sun exposure in adulthood per week (OR 2.03, 95%CI 1.09-3.81). The increased risk was consistent for high grade tumours and advanced stage prostate cancers. The findings from this study suggest that excessive sun exposure is a risk factor for prostate cancer in Asians.
Highlights
Prostate cancer is the commonest male cancer worldwide
We found that prostate cancer risk was increased in subjects with black/dark-brown eyes, darker skin colour e.g. tan/dark brown/black, frequent sunburn in lifetime and increased general sun exposure in adulthood per week
The aim of this study is to examine the association between sun exposure and pigment characteristics and risk of prostate cancer in an Asian population in Singapore which consisted of Chinese, Malays and Indians
Summary
Prostate cancer is the commonest male cancer worldwide. many epidemiological studies have been conducted in the last few decades to determine the risk factors associated with prostate cancer, till dated the only known established factors are age, race and family history (Patel et al, 2009).In the last decade, there were reports on the likely protective effect of sun exposure for prostate cancer, these reports were not consistent (Bodiwala et al, 2003; John et al, 2005; Gilbert et al, 2009; Nair-Shalliker et al, 2011; Lin et al, 2012). Since there have been case-control, cohort and ecological studies that reported on the protective nature of sun exposure and prostate cancer (Gilbert et al, 2009; Gupta et al, 2009; Lin et al, 2012). Gilbert et al reported a UK-wide nested case-control study, based on 1,020 prostate specific antigen-detected cases and 5,044 matched population controls and a systematic review with meta-analysis. They concluded that “Our data and meta-analyses provide limited support for the hypothesis that increased exposure to sun may reduce prostate cancer risk” (Gilbert et al, 2009).
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