Use of arsenic-induced palmoplantar hyperkeratosis and skin cancers to predict risk of subsequent internal malignancy

Ling I. Hsu, Gwo Shing Chen, Chih Hung Lee, Tse Yen Yang, Yu Hsin Chen, Yuan Hung Wang, Yu Mei Hsueh, Hung Yi Chiou, Meei Maan Wu, Chien Jen Chen

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Hyperpigmentation, hyperkeratoses, and Bowen's disease are hallmarks of chronic arsenic exposure. The association between arsenic-induced skin lesions and subsequent internal cancers is examined by using a community-based prospective study. The cohort was enrolled from an arseniasis-endemic area in southwestern Taiwan, where 2,447 residents participated in skin examinations during the late 1980s. The number of participants diagnosed with hyperpigmentation was 673; with hyperkeratosis, 243; and with skin cancer (Bowen's disease or non-melanoma skin cancer), 378. Newly diagnosed internal cancers were ascertained through linkage with National Cancer Registry profiles. Cox regression was performed to estimate hazard ratios with 95% confidence intervals for potential risk predictors. Compared with participants without skin lesions, patients affected with skin cancers had a significantly increased risk of lung cancer (hazard ratio = 4.64, 95% confidence interval: 2.92, 7.38) and urothelial carcinoma (hazard ratio = 2.02, 95% confidence interval: 1.23, 3.30) after adjustment for potential confounders and cumulative arsenic exposure. Hyperkeratosis is significantly associated with an increased lung cancer risk (hazard ratio = 2.76, 95% confidence interval: 1.35, 5.67). A significant interactive effect on lung cancer risk between hyperkeratosis and cigarette smoking was identified, which suggests that patients with hyperkeratosis who have been exposed to arsenic should cease smoking.

Original languageEnglish
Pages (from-to)202-212
Number of pages11
JournalAmerican Journal of Epidemiology
Volume177
Issue number3
DOIs
Publication statusPublished - Feb 2013

Keywords

  • arsenic
  • Bowen's disease
  • cohort study
  • hyperkeratosis
  • hyperpigmentation
  • internal malignancy
  • non-melanoma skin cancer

ASJC Scopus subject areas

  • Epidemiology

Fingerprint Dive into the research topics of 'Use of arsenic-induced palmoplantar hyperkeratosis and skin cancers to predict risk of subsequent internal malignancy'. Together they form a unique fingerprint.

  • Cite this