Gustav Boelsgaard Christensen, Christian Ingvar, Linda Werner Hartman, Håkan Olsson, Kari Nielsen
DOI: 10.2340/00015555-3198

The incidence of cutaneous squamous cell carcinoma has increased rapidly in Sweden in the past decades. Here, we present a prospective study of the Melanoma in Southern Sweden (MISS)-cohort, with 29,460 participating women in southern Sweden that investigates the risk factors for cutaneous squamous cell carcinoma. Data on the host and skin cancer risk factors were collected through questionnaires and then matched with the National Cancer Registry. Statistical analyses were based on uni- and multivariable Cox proportional hazards models, using age as the time-scale. We found that sunbed use (hazard ratio (HR) 1.2, 95% CI: 1.1–1.4), red and light blond hair (HR 1.6, 95% CI: 1.1–2.3), freckles (HR 1.4, 95% CI: 1.1–1.8) and immunosuppressive medications (HR 2.1, 95% CI: 1.3–4.5) were independent risk factors. Furthermore, we observed a dose-dependent relationship between sunbed use and the development of cutaneous squamous cell carcinoma. Our findings support the idea of integrating dermatological follow-up examinations for immunosuppressed patients and banning the use of sunbeds in order to prevent cutaneous squamous cell carcinoma.

There has been an increase in the number of skin cancers in Sweden in the last decades. We looked closer at one skin cancer in particular - squamous cell carcinoma. In order to be able to prevent squamous cell carcinoma, we need to understand which risk factors are most important. We studied a large group of Swedish women and looked into which risk factors play a role in getting squamous cell carcinoma. Having freckles and red or light blond hair , taking medications that suppress the immune system and using sunbeds play a part.