Abstract：
BACKGROUND: Psoralen + ultraviolet-A (PUVA) is associated with photocarcinogenesis. However, carcinogenic risk with other ultraviolet phototherapies remains unclear.
OBJECTIVE: Evaluate whether phototherapy without psoralens increases skin cancer risk.
METHODS: Retrospective cohort study of patients treated at a teaching-hospital phototherapy center (1977-2018). Skin cancer records were validated against pathology reports. Age-standardized incidence rates (ASIRs) of skin cancer were evaluated for gender, skin phototype, diagnosis, ultraviolet modality, anatomical site; and compared to provincial population incidence rates (2003).
RESULTS: In total, 3506 patients treated with broadband-ultraviolet-B, narrowband-UVB and/or combined UVAB were assessed with a mean follow-up of 7.3 years. Majority of patients had psoriasis (60.9%) or eczema (26.4%). Median number of treatments was 43 (1-3598). Overall, 170 skin cancers (17 melanoma, 33 squamous cell carcinoma and 120 basal cell carcinoma) occurred in 79 patients. Patient-based and tumor-based ASIR of skin cancer was 149 (95% CI: 112-187)/100,000 and 264 (219-309)/100,000 person-years, respectively. There was no significant difference between tumor-based ASIRs for melanoma, squamous cell carcinoma, and basal cell carcinoma compared to the general population; or in phototherapy patients with-psoriasis or eczema; or immunosuppressants. No cumulative dose-response correlation between UVB and skin cancer was seen.
CONCLUSIONS: Treatment and follow-up duration.
CONCLUSIONS: No increased risk of melanoma and keratinocyte cancer was found with phototherapy.
OBJECTIVE: Evaluate whether phototherapy without psoralens increases skin cancer risk.
METHODS: Retrospective cohort study of patients treated at a teaching-hospital phototherapy center (1977-2018). Skin cancer records were validated against pathology reports. Age-standardized incidence rates (ASIRs) of skin cancer were evaluated for gender, skin phototype, diagnosis, ultraviolet modality, anatomical site; and compared to provincial population incidence rates (2003).
RESULTS: In total, 3506 patients treated with broadband-ultraviolet-B, narrowband-UVB and/or combined UVAB were assessed with a mean follow-up of 7.3 years. Majority of patients had psoriasis (60.9%) or eczema (26.4%). Median number of treatments was 43 (1-3598). Overall, 170 skin cancers (17 melanoma, 33 squamous cell carcinoma and 120 basal cell carcinoma) occurred in 79 patients. Patient-based and tumor-based ASIR of skin cancer was 149 (95% CI: 112-187)/100,000 and 264 (219-309)/100,000 person-years, respectively. There was no significant difference between tumor-based ASIRs for melanoma, squamous cell carcinoma, and basal cell carcinoma compared to the general population; or in phototherapy patients with-psoriasis or eczema; or immunosuppressants. No cumulative dose-response correlation between UVB and skin cancer was seen.
CONCLUSIONS: Treatment and follow-up duration.
CONCLUSIONS: No increased risk of melanoma and keratinocyte cancer was found with phototherapy.
摘要：
背景：补骨脂素+紫外线-A（PUVA）与光致癌作用有关。然而,其他紫外线照射的致癌风险尚不清楚。
目的：评估没有补骨脂素的光疗是否会增加皮肤癌风险。
方法：在教学医院光疗中心接受治疗的患者的回顾性队列研究（1977-2018）。针对病理学报告验证皮肤癌记录。评估了皮肤癌的年龄标准化发病率（ASIR）的性别，皮肤照型，诊断,紫外线模态,解剖部位；并与省级人口发病率进行比较（2003年）。
结果：总计，3506例接受宽带紫外线治疗的患者，对窄带UVB和/或联合UVAB进行评估,平均随访7.3年.大多数患者有银屑病（60.9%）或湿疹（26.4%）。治疗的中位数是43(1-3598)。总的来说,170例皮肤癌（17例黑色素瘤，79例患者中发生鳞状细胞癌33例，基底细胞癌120例）。皮肤癌的基于患者和基于肿瘤的ASIR为149（95％CI：112-187）/100,000和264（219-309）/100,000人年，分别。黑色素瘤的基于肿瘤的ASIR之间没有显着差异，鳞状细胞癌,与普通人群相比，基底细胞癌；或患有牛皮癣或湿疹的光疗患者；或免疫抑制剂。未观察到UVB与皮肤癌之间的累积剂量反应相关性。
结论：治疗和随访时间。
结论：光疗未发现黑色素瘤和角质形成细胞癌的风险增加。
目的：评估没有补骨脂素的光疗是否会增加皮肤癌风险。
方法：在教学医院光疗中心接受治疗的患者的回顾性队列研究（1977-2018）。针对病理学报告验证皮肤癌记录。评估了皮肤癌的年龄标准化发病率（ASIR）的性别，皮肤照型，诊断,紫外线模态,解剖部位；并与省级人口发病率进行比较（2003年）。
结果：总计，3506例接受宽带紫外线治疗的患者，对窄带UVB和/或联合UVAB进行评估,平均随访7.3年.大多数患者有银屑病（60.9%）或湿疹（26.4%）。治疗的中位数是43(1-3598)。总的来说,170例皮肤癌（17例黑色素瘤，79例患者中发生鳞状细胞癌33例，基底细胞癌120例）。皮肤癌的基于患者和基于肿瘤的ASIR为149（95％CI：112-187）/100,000和264（219-309）/100,000人年，分别。黑色素瘤的基于肿瘤的ASIR之间没有显着差异，鳞状细胞癌,与普通人群相比，基底细胞癌；或患有牛皮癣或湿疹的光疗患者；或免疫抑制剂。未观察到UVB与皮肤癌之间的累积剂量反应相关性。
结论：治疗和随访时间。
结论：光疗未发现黑色素瘤和角质形成细胞癌的风险增加。
