Heterogeneity in Host Risk Factors for Incident Melanoma and Non-Melanoma Skin Cancer in a Cohort of US Women

Background: Melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC) are 3 types of skin cancer that have distinct biologic characteristics and prognoses. We evaluated phenotypic differences in the risk of these cancers in US women. Methods: We conducted a prospective study of 113 139 female nurses from 1984 to 2002. Over the 18 years of follow-up, there were 375 cases of melanoma, 495 cases of SCC, and 9423 cases of BCC. Results: Women with melanoma were more likely to have a family history of melanoma (melanoma: RR 1.94, 95% confidence interval [CI] 1.36-2.76; SCC: RR 0.82, 95% CI 0.58-1.37; BCC: RR 1.49, 95% Cl 1.38-1.62) and 6 or more moles on the left arm (melanoma: RR 3.66, 95% CI 2.15-6.24; SCC: RR 1.53, 95% CI 0.83-2.79; BCC: RR 1.48, 95% CI 1.28-1.72). Polytomous logistic regression analysis showed that age at diagnosis (P < 0.0001), family history of melanoma (P = 0.016), and number of moles on the left arm (P = 0.007) were significantly different across the 3 cancers. Conclusions: This prospective observational study demonstrated that known phenotypic factors for skin cancer have a differential impact on the risk of melanoma, SCC, and BCC.