The development of skin cancer is multifactorial. It is considered indisputable that chronic light damage to the skin by ultraviolet radiation is the most important factor in the etiology of squamous cell carcinoma.
Via direct and indirect effects, UV exposure causes damage to the DNA of epidermal keratinocytes. In the case of excessive exposure and in old age, the repair mechanisms can be overtaxed, as a result of which carcinogenic mutations can arise. Approximately 90 percent of all squamous cell carcinomas occur on sun-exposed sites such as the hairless capillitium, forehead, bridge of the nose, ear helices, forearms, and back of the hands [1]. In Germany, squamous cell carcinoma is classified as an occupational disease due to occupational UV exposure in workers with a high proportion of outdoor activities, such as construction workers in building construction, workers in agriculture or horticulture [2]. A secondary analysis found that the pooled odds ratio (OR) for the association between outdoor work and the risk of developing squamous cell carcinoma was 1.77 (95% CI: 1.40-2.22) [3,4]. And dose-response modeling showed a significant increase in disease risk for squamous cell carcinomas at UV exposures above the 40th percentile – in this range, the model curve showed exponential behavior [5].
Literature:
- Trautinger F, Beichl-Zwiauer V: Squamous cell carcinoma of the skin. DFP Literature Study. Austrian Medical Journal 2021; 13/14, 15.07.2021
- Federal Ministry of Labor and Social Affairs: Scientific justification for the occupational disease “squamous cell carcinoma or multiple actinic keratoses of the skin caused by natural UV radiation”. Joint Ministerial Gazette, Aug. 12, 2013, pp. 671-693.
- Schmitt J, et al: Occupational ultraviolet light exposure increases the risk for the development of cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Br J Dermatol 2011; 164(2): 291-307.
- Strehl C, Wittlich M: Skin cancer caused by natural UV radiation. Zbl Arbeitsmed 2021; 71: 262-269.
- Schmitt J, et al: Is ultraviolet exposure acquired at work the most important risk factor for cutaneous squamous cell carcinoma? Results of the population-based case-control study FB-181. Br J Dermatol 2018; 178(2): 462-472.
DERMATOLOGIE PRAXIS 2022; 32(3): 32
