Table. Cumulative History of Health Care Screening Practices and Risk of Melanoma, Squamous Cell Carcinoma, and Basal Cell Carcinoma.
| Health Screening Practice | Basal Cell Carcinoma | Squamous Cell Carcinoma | Melanoma | ||||||
|---|---|---|---|---|---|---|---|---|---|
| No. Exposed | HR (95% CI) | No. Exposed | HR (95% CI) | No. Exposed | HR (95% CI) | ||||
| Age Adjusted | MV Adjusteda | Age Adjusted | MV Adjusteda | Age Adjusted | MV Adjusteda | ||||
| Nurses’ Health Studyb | |||||||||
| Physical examination | |||||||||
| Overall | 14 032 | 1.51 (1.34-1.70) | 1.46 (1.30-1.64) | 1501 | 2.45 (1.49-4.02) | 2.32 (1.41-3.80) | 497 | 1.72 (0.88-3.34) | 1.66 (0.85-3.22) |
| For screening | 11 398 | 1.50 (1.33-1.68) | 1.45 (1.29-1.63) | 1225 | 2.43 (1.48-3.99) | 2.31 (1.40-3.79) | 411 | 1.73 (0.89-3.36) | 1.68 (0.86-3.27) |
| For symptoms | 2634 | 1.59 (1.40-1.79) | 1.51 (1.34-1.71) | 276 | 2.53 (1.53-4.20) | 2.36 (1.42-3.91) | 86 | 1.67 (0.83-3.33) | 1.56 (0.78-3.13) |
| Colonoscopy or sigmoidoscopy | 8841 | 1.31 (1.26-1.35) | 1.28 (1.23-1.33) | 1006 | 1.42 (1.27-1.59) | 1.38 (1.23-1.54) | 301 | 1.27 (1.05-1.53) | 1.24 (1.03-1.50) |
| Eye examination | 13 778 | 1.45 (1.31-1.60) | 1.43 (1.29-1.58) | 1479 | 1.52 (1.06-2.18) | 1.47 (1.03-2.10) | 481 | 0.99 (0.62-1.58) | 0.98 (0.62-1.56) |
| Serum cholesterol test | 12 691 | 1.48 (1.35-1.63) | 1.45 (1.31-1.60) | 1415 | 2.28 (1.60-3.24) | 2.14 (1.50-3.06) | 441 | 0.93 (0.62-1.39) | 0.91 (0.60-1.38) |
| Mammography | 13 614 | 1.66 (1.53-1.79) | 1.61 (1.48-1.74) | 1461 | 1.85 (1.40-2.43) | 1.75 (1.33-2.31) | 482 | 1.61 (1.05-2.45) | 1.59 (1.04-2.43) |
| Breast examination | 13 867 | 1.57 (1.43-1.74) | 1.53 (1.38-1.69) | 1491 | 2.54 (1.72-3.75) | 2.41 (1.63-3.55) | 483 | 1.01 (0.65-1.58) | 0.99 (0.65-1.53) |
| Pelvic examination | 13 963 | 1.44 (1.28-1.63) | 1.39 (1.23-1.57) | 1493 | 2.12 (1.36-3.30) | 1.97 (1.27-3.07) | 491 | 1.06 (0.60-1.89) | 1.03 (0.58-1.83) |
| Health Professionals Follow-up Studyc | |||||||||
| Physical examination | |||||||||
| Overall | 8495 | 1.47 (1.29-1.67) | 1.43 (1.26-1.63) | 1172 | 2.05 (1.30-3.23) | 1.85 (1.17-2.92) | 451 | 1.10 (0.68-1.77) | 1.04 (0.64-1.69) |
| For screening | 7407 | 1.47 (1.29-1.67) | 1.44 (1.26-1.64) | 1020 | 2.04 (1.29-3.22) | 1.83 (1.16-2.90) | 380 | 1.06 (0.66-1.72) | 1.01 (0.62-1.64) |
| For symptoms | 1088 | 1.45 (1.26-1.67) | 1.42 (1.23-1.63) | 152 | 2.11 (1.30-3.40) | 1.91 (1.18-3.09) | 71 | 1.30 (0.77-2.19) | 1.22 (0.72-2.06) |
| Colonoscopy or sigmoidoscopy | 6508 | 1.21 (1.15-1.27) | 1.21 (1.15-1.27) | 905 | 1.14 (1.00-1.31) | 1.13 (0.98-1.29) | 333 | 1.06 (0.86-1.31) | 1.05 (0.85-1.29) |
| Eye examination | 8293 | 1.28 (1.15-1.41) | 1.23 (1.11-1.37) | 1149 | 1.48 (1.07-2.03) | 1.21 (0.87-1.68) | 441 | 1.20 (0.79-1.83) | 1.10 (0.72-1.69) |
| Serum cholesterol test | 8456 | 1.44 (1.28-1.62) | 1.40 (1.24-1.58) | 1156 | 1.36 (0.97-1.90) | 1.21 (0.86-1.70) | 453 | 1.43 (0.86-2.36) | 1.34 (0.81-2.23) |
| Prostate-specific antigen test | 6484 | 1.45 (1.35-1.56) | 1.42 (1.32-1.53) | 982 | 1.79 (1.46-2.21) | 1.64 (1.33-2.02) | 329 | 1.21 (0.91-1.62) | 1.15 (0.86-1.54) |
| Rectal examination | 8159 | 1.33 (1.22-1.46) | 1.30 (1.20-1.42) | 1125 | 1.27 (0.98-1.63) | 1.17 (0.91-1.51) | 439 | 1.47 (1.01-2.15) | 1.40 (0.96-2.05) |
| Pooled | |||||||||
| Physical examination: overall | NA | NA | 1.45 (1.33-1.58) | NA | NA | 2.05 (1.46-2.87) | NA | NA | 1.24 (0.80-1.92) |
Abbreviations: HR, hazard ratio; MV, multivariable; NA, not applicable.
a
Adjusted for family history of melanoma, natural hair color, number of arm moles, sunburn susceptibility as a child/adolescent, number of lifetime blistering sunburns, and UV flux since baseline.
b
Basal cell carcinoma, 14 319 incident occurrences; squamous cell carcinoma, 1517; and melanoma, 506.
c
Basal cell carcinoma, 8741 incident occurrences; squamous cell carcinoma, 1191; and melanoma, 469.