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The association between non-melanoma skin cancer and osteoporotic fractures—a population-based record linkage study

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Abstract

Summary

We studied the association between osteoporotic fractures and prior non-melanoma skin cancer (NMSC, a biomarker for cumulative sun exposure). The risk of prior NMSC in our fracture cohort was significantly reduced (standardised incidence ratio 0.69, 95% CI 0.61, 0.78). Adequate lifetime sun exposure may be necessary to protect against osteoporotic fractures in later life.

Introduction

The relationship between cumulative sun exposure and osteoporotic fractures is uncertain. We aimed to study the association between non-melanoma skin cancer (NMSC), a marker of cumulative sun exposure, and osteoporotic fractures in an older cohort.

Methods

A retrospective cohort study in southern Tasmania in people aged at least 50 years with incident radiographic fracture (n = 2,283) was carried out. By record linkage to the Tasmanian Cancer Registry the cohort was followed backwards through time until the occurrence of NMSC or end-of follow-up. Relative risk was estimated by the standardised incidence ratio (SIR) using sex-, age- and calendar year-specific cancer incidence rates in southern Tasmania as reference.

Results

The incidence of prior NMSC in the fracture cohort was 31% lower than for the general population (SIR 0.69, 95% CI 0.61, 0.78). This effect was significant for most fracture subtypes except pelvic and wrist fractures and observed for both NMSC subtypes, squamous cell carcinoma and basal cell carcinoma.

Conclusions

Older people with osteoporotic fractures may have had lifestyles linked to lower cumulative sunlight exposure. Achieving a balance between adequate lifetime sun exposure and protection against its adverse effects (such as fractures and skin cancer) may require assessment of individual risks.

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Acknowledgements

The Southern Tasmanian Fracture Registry was supported in part by a grant from Merck, Sharp and Dohme and H.C. was supported by a McGill Fellowship from the Arthritis Foundation of Australia. The Tasmanian Cancer Registry is supported by funding from the Department of Health and Human Services, Tasmania , the Cancer Council of Tasmania and the Tasmanian Community Fund. V.S. was supported by a post-doctoral fellowship from a National Health and Medical Research Council Capacity Building Grant. G.J. is supported by a National Health and Medical Research Council Practitioner Fellowship. V.S. had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Menzies Research Institute, University of Tasmania, Hobart, 7001, Australia

    V. Srikanth, J. Fryer, A. Venn, L. Blizzard, L. Newman, H. Cooley, T. Albion & G. Jones

  2. Department of Medicine, Monash Medical Centre, Monash University, Melbourne, 3930, Australia

    V. Srikanth

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  1. V. Srikanth
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  2. J. Fryer
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  3. A. Venn
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  4. L. Blizzard
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  6. H. Cooley
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  7. T. Albion
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  8. G. Jones
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Correspondence to V. Srikanth.

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Srikanth, V., Fryer, J., Venn, A. et al. The association between non-melanoma skin cancer and osteoporotic fractures—a population-based record linkage study. Osteoporos Int 18, 687–692 (2007). https://doi.org/10.1007/s00198-006-0303-y

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  • DOI: https://doi.org/10.1007/s00198-006-0303-y

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