Cohort Study of Nonmelanoma Skin Cancer and the Risk of Exfoliation Glaucoma

Jae H. Kang, Trang Vopham, Francine Laden, Bernard A. Rosner, Barbara Wirostko, Robert Ritch, Janey L. Wiggs, Abrar Qureshi, Hongmei Nan, Louis R. Pasquale

Research output: Contribution to journalArticle

Abstract

In a cohort study of 120,307 participants with 25+ years of follow-up, a history of nonmelanoma skin cancer (NMSC) was associated with a 40% higher exfoliation glaucoma (XFG) risk.The purpose of this study was to evaluate the relationship between NMSC (a marker of ultraviolet radiation exposure) and XFG.Methods:We performed a cohort study of US women (n=79,102; 1980-2014) and men (n=41,205; 1986-2014), aged 40+ years and at risk for glaucoma who reported eye examinations. From 1984 (women)/1988 (men), we asked about basal cell carcinoma or squamous cell carcinoma history separately; in prior years, we asked about any NMSC history in a single question. Squamous cell carcinoma was confirmed with histopathology reports while basal cell carcinoma and any early (<1984/<1988) NMSC history was self-reported. Incident XFG cases (362 women and 83 men) were confirmed with medical records. Using pooled data, we estimated multivariable-adjusted relative risks [MVRRs; 95% confidence intervals (CIs)] with Cox proportional hazards models that were stratified by age (in mo), 2-year time period at risk and average lifetime residential latitude.Results:In multivariable-adjusted analyses, we observed a 40% higher XFG risk with any NMSC history (MVRR=1.40; 95% CI=1.08-1.82); the association was observed even with 4 and 8-year lags in NMSC history. Also, the NMSC association was stronger in younger (below 65 y; MVRR=2.56; 95% CI=1.62-4.05) versus older participants (65 y and above; MVRR=1.25; 95% CI=0.94-1.66; P for interaction=0.01) and those living in the northern latitudes (≥42°N; MVRR=1.92; 95% CI=1.28-2.88) versus more southern latitudes (<42°N; MVRR=1.19; 95% CI=0.86-1.66; P for interaction=0.04).Conclusion:NMSC was associated with higher XFG risk, particularly among younger participants and those living in the Northern US.

Original languageEnglish (US)
Pages (from-to)448-455
Number of pages8
JournalJournal of glaucoma
Volume29
Issue number6
DOIs
StatePublished - Jun 1 2020

Keywords

  • epidemiology
  • exfoliation syndrome
  • glaucoma
  • skin cancer
  • ultraviolet light

ASJC Scopus subject areas

  • Ophthalmology

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    Kang, J. H., Vopham, T., Laden, F., Rosner, B. A., Wirostko, B., Ritch, R., Wiggs, J. L., Qureshi, A., Nan, H., & Pasquale, L. R. (2020). Cohort Study of Nonmelanoma Skin Cancer and the Risk of Exfoliation Glaucoma. Journal of glaucoma, 29(6), 448-455. https://doi.org/10.1097/IJG.0000000000001496